Individual provider Active NPI

Jorge Luis Rodriguez, MD

  • Surgery Physician
  • Pasadena, TX
National Provider Identifier
1760470561
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
H3512 Issued in TX
Practice address
5413 Crenshaw Rd
Suite 100
Pasadena, TX 77505-3143
Phone
(713) 477-2283
Fax
(713) 475-5986
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X H3512 TX Primary

Addresses

Primary practice location

5413 Crenshaw Rd
Suite 100
Pasadena, TX 77505-3143

Mailing address

5413 Crenshaw Rd
Suite 100
Pasadena, TX 77505-3143
Phone (713) 477-2283

Other identifiers 2

IdentifierTypeStateIssuer
114519503MedicaidTX
89X760OtherTXPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20101116001102 TX Practitioner - General Surgery 6709986698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5413 Crenshaw Rd
Pasadena, TX 77505-3143
Phone (713) 477-2283

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H3512TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pasadena Surgical Association Surgery CurrentSince Mar 21, 1988 Accepting new patients

Locations

5413 Crenshaw Rd
Ste 100
Pasadena, TX 77505
Phone (713) 477-2283

Interoperability endpoints

  • Direct secure messaging: jrodriguez468830@direct.stlukeshealth.org

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 1

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1760470561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5413 CRENSHAW RD",
            "address_2": "SUITE 100",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053143",
            "telephone_number": "713-477-2283",
            "fax_number": "713-475-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5413 CRENSHAW RD",
            "address_2": "SUITE 100",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053143",
            "telephone_number": "713-477-2283",
            "fax_number": "713-475-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "H3512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114519503",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "89X760",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.