Jesus Ivan Rodriguez-Carrillo, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

355152 Issued in NY

Practice address

525 E 68TH St # 10065
New York, NY 10065-4870

Phone

(575) 644-3509

NPI assigned

May 30, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1245355270
  Medicare reassignment Care Compare group NPD
• Matrix Medical of New York PC

  • Nurse Practitioner
  • New York, NY
  • NPI 1639433063
  Medicare reassignment NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD
• Weill Medical College of Cornell

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1205882586
  NPD

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1720828429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7423 SILVERTHORNE RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871143753",
            "telephone_number": "575-644-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST # 10065",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "575-644-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-CARRILLO",
        "first_name": "JESUS",
        "middle_name": "IVAN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NM",
            "license": "81732",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355152",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "941836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Rodriguez-Barrera, PA-C
• Adriana Rodriguez-Boseman, LCSW
• Sandy Rodriguez-Calixto
• Gabriela Rodriguez-Caprio, MD
• Maria Pilar Rodriguez-Cardenas, D.D.S.
• Cesar Amaury Rodriguez-Diaz, M.D.
• Mercedes Eugenia Rodriguez-Diaz, M.D.
• Sebastian R Rodriguez-Elizalde, MD, FRCPC
• Josanna Mari Rodriguez-Lopez, M.D.
• Marilyn Desiree Rodriguez-Navarro

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.