Individual provider Active NPI

Heriberto Rodriguez Jr., MD

  • Family Medicine Physician
  • Gretna, LA
National Provider Identifier
1811480908
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125.072987 Issued in IL
Practice address
601 Terry Pkwy Ste O
Gretna, LA 70056-4300
Phone
(504) 534-1229
Fax
(504) 553-1176
NPI assigned
Jun 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 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 125.072987 IL Primary

Addresses

Primary practice location

601 Terry Pkwy Ste O
Gretna, LA 70056-4300

Mailing address

PO Box 746721
Atlanta, GA 30374-6721
Phone (312) 733-9730

Other practice location 1

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 864-6000

Other practice location 2

3010 W 26th St
Chicago, IL 60623-4128
Phone (847) 220-4103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210820002520 IL Practitioner - Family Practice 6800291386 Reassigns benefits to 1 organization
I20231109002403 LA Practitioner - Family Practice 6800291386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

230 Ochsner Blvd
Gretna, LA 70056-5246
Phone (504) 529-5558

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.072987ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Thomas Community Health Center, Inc. CurrentSince Feb 1, 2024 Accepting new patients
St. Thomas Community Health Center, Inc CurrentSince Feb 1, 2024 Accepting new patients
Oak Street Health Physicians Group, PC CurrentSince Aug 2, 2021 Accepting new patients
St. Thomas Community Health Center, Inc Past Accepting new patients
St. Thomas Community Health Center, Inc. Past Accepting new patients
St. Thomas Community Health Center, Inc Past Accepting new patients
St. Thomas Community Health Center, Inc. Past Accepting new patients
Osh-in Physicians Group, PC Family Medicine Past Accepting new patients
St. Thomas Community Health Center, Inc. Past Accepting new patients

Locations

7000 Cermak Rd
Berwyn, IL 60402
Phone (708) 484-8090

3010 W 26th St
Chicago, IL 60623
Phone (847) 220-4103

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

230 Ochsner Blvd
Gretna, LA 70056

2014 Magazine St
New Orleans, LA 70130
Phone (504) 529-9115

2010 Magazine St
New Orleans, LA 70130

3221 General Degaulle Dr
New Orleans, LA 70114

1020 Saint Andrew St
New Orleans, LA 70130

3500 Holiday Dr
New Orleans, LA 70114
Phone (504) 367-5724

2000 Magazine St
New Orleans, LA 70130
Phone (504) 529-5888

1936 Magazine St
New Orleans, LA 70130

Organizations & group practices 9

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1811480908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746721",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746721",
            "telephone_number": "312-733-9730",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 TERRY PKWY STE O",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700564300",
            "telephone_number": "504-534-1229",
            "fax_number": "504-553-1176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 W Harrison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123714",
            "country_code": "US",
            "telephone_number": "312-864-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3010 W 26th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606234128",
            "country_code": "US",
            "telephone_number": "847-220-4103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "HERIBERTO",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-13",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.072987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.