Individual provider Active NPI

Rafael Arredondo, MD

  • Otolaryngology Physician
  • Brownsville, TX
National Provider Identifier
1689749301
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
E5342 Issued in TX
Practice address
1084 E Los Ebanos Blvd
Brownsville, TX 78520-9988
Phone
(956) 544-2703
Fax
(956) 541-1527
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X E5342 TX Primary

Addresses

Primary practice location

1084 E Los Ebanos Blvd
Brownsville, TX 78520-9988

Mailing address

1084 E Los Ebanos Blvd
Brownsville, TX 78520-9988
Phone (956) 544-2703

Other identifiers 1

IdentifierTypeStateIssuer
126272701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120307000025 TX Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive SurgeryPractitioner - Maxillofacial Surgery 0547429896 Practice locations: Brownsville, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1689749301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 E LOS EBANOS BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785209988",
            "telephone_number": "956-544-2703",
            "fax_number": "956-541-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1084 E LOS EBANOS BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785209988",
            "telephone_number": "956-544-2703",
            "fax_number": "956-541-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARREDONDO",
        "first_name": "RAFAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "E5342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126272701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.