Individual provider Active NPI

Michael Jose Rodriguez, APRN

  • Family Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1699499467
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11260 Issued in CT
Practice address
175 Sherman Ave
New Haven, CT 06511-4357
Phone
(203) 789-3363
Fax
(203) 789-4081
NPI assigned
Sep 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 140147 CT
Family Nurse Practitioner 363LF0000X 11260 CT Primary

Addresses

Primary practice location

175 Sherman Ave
New Haven, CT 06511-4357

Mailing address

41 Rivercliff Dr
Milford, CT 06460-5025
Phone (203) 809-4504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230124003297 CT Practitioner - Nurse Practitioner 3173994464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

84 N Main St
Branford, CT 06405-3061
Phone (203) 483-8300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11260CTMDGeneral Practice Dentistry
140147CTMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Current Accepting new patients
Yale University CurrentSince Jan 3, 2023 Accepting new patients
Yale University CurrentSince Jan 3, 2023 Accepting new patients

Locations

84 N Main St
Branford, CT 06405
Phone (203) 483-2015

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

175 Sherman Ave
New Haven, CT 06511
Phone (203) 562-5115

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

2 Devine St
North Haven, CT 06473
Phone (203) 747-7300

Interoperability endpoints

  • Direct secure messaging: mrodriguez319322@direct.ynhh.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1699499467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 RIVERCLIFF DR",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064605025",
            "telephone_number": "203-809-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 SHERMAN AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114357",
            "telephone_number": "203-789-3363",
            "fax_number": "203-789-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MICHAEL",
        "middle_name": "JOSE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-26",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CT",
            "license": "140147",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "11260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.