NPIMap

Individual provider Active NPI

Desarae Rodriguez, APRN

  • Acute Care Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1811742935
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4015679 Issued in KY
Practice address
401 E Chestnut St Unit 690
Louisville, KY 40202-5706
Phone
(502) 587-4384
NPI assigned
Apr 22, 2024
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4015679 KY Primary

Addresses

Primary practice location

401 E Chestnut St Unit 690
Louisville, KY 40202-5706

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-4710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240520003467 KY Practitioner - Nurse Practitioner 3173965316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 E Chestnut St
Suite 610
Louisville, KY 40202-5711
Phone (502) 813-6600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4015679KYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince May 1, 2024 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians CurrentSince May 1, 2024 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

401 E Chestnut St
Unit 610
Louisville, KY 40202
Phone (502) 588-4450

401 E Chestnut St
Unit 690
Louisville, KY 40202
Phone (502) 588-4710

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Organizations & group practices 4

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 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1811742935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST UNIT 690",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025706",
            "telephone_number": "502-587-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DESARAE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "4015679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.