Individual provider Active NPI

Angelina Rodriguez

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1821808528
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
226367 Issued in AZ
Practice address
3808 N Kings Peak
Mesa, AZ 85215-7750
Phone
(480) 287-6043
NPI assigned
Jan 13, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 226367 AZ Primary

Addresses

Primary practice location

3808 N Kings Peak
Mesa, AZ 85215-7750

Mailing address

3808 N Kings Peak
Mesa, AZ 85215-7750
Phone (480) 287-6043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260527001427 AZ Practitioner - Nurse Practitioner 2163992546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community 43Group PAC ID 2860878584, 2 clinicians

Practice addresses (Care Compare)

4343 N 16TH St
Phoenix, AZ 85016-5338
Phone 60227443432001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
226367AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community 43 CurrentSince Feb 28, 2026 Accepting new patients
Highland Medical Center, PC PastSince Feb 28, 2026 Accepting new patients

Locations

4343 N 16th St
Phoenix, AZ 85016
Phone (602) 223-1711

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26465/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1821808528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 N KINGS PEAK",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852157750",
            "telephone_number": "480-287-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 N KINGS PEAK",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852157750",
            "telephone_number": "480-287-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ANGELINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "226367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.