Individual provider Active NPI

Jeanette Rodriguez, DO

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1750776829
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS15071 Issued in FL
Practice address
14100 58TH St N
Clearwater, FL 33760-9900
Phone
(727) 824-8181
NPI assigned
Apr 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS15071 FL Primary

Addresses

Primary practice location

14100 58TH St N
Clearwater, FL 33760-9900

Mailing address

14100 58TH St N
Clearwater, FL 33760-9900
Phone (727) 824-8181

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
I20200327001140 FL Practitioner - Family Practice 2365702412 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS15071FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Pinellas Inc Family Medicine Current Accepting new patients
Community Health Centers of Pinellas Inc. Family Medicine CurrentSince Feb 16, 2020 Accepting new patients
Community Health Centers of Pinellas Inc. CurrentSince Feb 16, 2020 Accepting new patients

Locations

707 Druid Rd E
Clearwater, FL 33756
Phone (727) 441-8963

14100 58th St N
Ste 100
Clearwater, FL 33760
Phone (727) 286-6224

14100 58th St N
Clearwater, FL 33760

7550 43rd St N
Pinellas Park, FL 33781
Phone (727) 290-4222

1344 22nd St S
St Petersburg, FL 33712
Phone (727) 821-6701

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.

NPI Registry JSON

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

{
    "created_epoch": "1428192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1750776829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JEANETTE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-05",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS15071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.