Individual provider Active NPI

Cres Antonio Rodriguez, M.D.

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1740213628
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME51442 Issued in FL
Practice address
6919 N Dale Mabry Hwy Ste 100
Tampa, FL 33614-3972
Phone
(813) 915-5555
Fax
(813) 931-7508
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME51442 FL Primary

Addresses

Primary practice location

6919 N Dale Mabry Hwy Ste 100
Tampa, FL 33614-3972

Mailing address

6919 N Dale Mabry Hwy Ste 100
Tampa, FL 33614-3972
Phone (813) 915-5555

Other identifiers 1

IdentifierTypeStateIssuer
047016300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101215000657 FL Practitioner - Internal Medicine 2163619230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Management of Florida IncGroup PAC ID 3971678558, 158 clinicians

Practice addresses (Care Compare)

2155 SE Federal Hwy
Wellmed at South Stuart
Stuart, FL 34994-4514
Phone (772) 223-9630

6919 N Dale Mabry Hwy 320
Wellmed at Carrollwood
Tampa, FL 33614-3972
Phone (813) 915-5555

Hospital & facility affiliations

  • Origin Home Health Care Home health agency, Apollo Beach, FL, CCN 109060
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME51442FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Management of Florida Inc CurrentSince Aug 30, 2021 Accepting new patients

Locations

2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982
Phone (407) 423-5178

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

6919 N Dale Mabry Hwy
Ste 100
Tampa, FL 33614
Phone (813) 680-1405

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: cres.rodriguez@wellmed.eclinicaldirectplus.com

Organizations & group practices 1

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 3

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1740213628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6919 N DALE MABRY HWY STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336143972",
            "telephone_number": "813-915-5555",
            "fax_number": "813-931-7508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6919 N DALE MABRY HWY STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336143972",
            "telephone_number": "813-915-5555",
            "fax_number": "813-931-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CRES",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME51442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047016300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.