Individual provider Active NPI

Nicole Rodriguez, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Tamarac, FL
National Provider Identifier
1750790036
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3702 Issued in FL
Practice address
8307 NW 88TH Ave
Tamarac, FL 33321-1539
Phone
(954) 721-3411
Fax
(954) 721-3772
NPI assigned
Aug 12, 2014
Last updated
May 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO3702 FL Primary

Addresses

Primary practice location

8307 NW 88TH Ave
Tamarac, FL 33321-1539

Mailing address

8307 NW 88TH Ave
Tamarac, FL 33321-1539
Phone (954) 721-3411

Other practice location 1

252 S Flamingo Rd
Pembroke Pines, FL 33027-1721
Phone (954) 721-3411

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031001943 FL Practitioner - Podiatry 8022315738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8307 NW 88TH Ave
Tamarac, FL 33321-1539
Phone (954) 721-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue149
Removal of skin lesions34
Removal of nail tissue1476
Removal or shaving of skin growth1022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Podiatry Associates, P.a. CurrentSince May 4, 2022 Accepting new patients

Locations

252 S Flamingo Rd
Pembroke Pines, FL 33027
Phone (954) 431-8855

8307 NW 88th Ave
Tamarac, FL 33321
Phone (954) 721-3411

Interoperability endpoints

  • Direct secure messaging: nrodriguez@laurawhitedpm.mdlogic.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1750790036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8307 NW 88TH AVE",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333211539",
            "telephone_number": "954-721-3411",
            "fax_number": "954-721-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8307 NW 88TH AVE",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333211539",
            "telephone_number": "954-721-3411",
            "fax_number": "954-721-3772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "252 S Flamingo Rd",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330271721",
            "country_code": "US",
            "telephone_number": "954-721-3411",
            "fax_number": "954-721-3772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

Verify at the official NPI Registry.