Individual provider Active NPI

Kenia Rodriguez, PSYD

  • Clinical Psychologist
  • Orlando, FL
National Provider Identifier
1740598762
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY8149 Issued in FL
Practice address
32 W Gore St
Orlando, FL 32806-1134
Phone
(321) 841-3820
Fax
(321) 843-6836
NPI assigned
Sep 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY8149 FL
Clinical Psychologist 103TC0700X PY8149 FL Primary

Addresses

Primary practice location

32 W Gore St
Orlando, FL 32806-1134

Mailing address

32 W Gore St
Orlando, FL 32806-1134
Phone (321) 841-3820

Other identifiers 2

IdentifierTypeStateIssuer
N/AMedicaidFL
PY8149OtherFLMEDICAL LICENSE

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101228000145 FL Practitioner - Clinical Psychologist 8921296476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

32 W Gore St
Orlando, FL 32806-1134
Phone (321) 841-3820

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY8149FLMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Clinical Neuropsychologist CurrentSince Dec 22, 2010 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 22, 2010 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Inc Past Accepting new patients
Orlando Health Inc Past Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

32 W Gore St
Fl 2
Orlando, FL 32806
Phone (321) 841-3220

Interoperability endpoints

  • Direct secure messaging: krodriguezspengler32015@orlandohealth.medalliesdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1740598762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 W GORE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061134",
            "telephone_number": "321-841-3820",
            "fax_number": "321-843-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 W GORE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061134",
            "telephone_number": "321-841-3820",
            "fax_number": "321-843-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KENIA",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY8149",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N/A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PY8149",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.