Individual provider Active NPI

Alexandra Rodriguez, PNP

  • Pediatric Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1831614882
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP134744 Issued in TX
Practice address
3612 Pera Ave
El Paso, TX 79905-2412
Phone
(915) 533-7057
Fax
(915) 533-7197
NPI assigned
Aug 10, 2017
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP134744 TX Primary

Addresses

Primary practice location

3612 Pera Ave
El Paso, TX 79905-2412

Mailing address

3612 Pera Ave
El Paso, TX 79905-2412
Phone (915) 533-7057

Other identifiers 1

IdentifierTypeStateIssuer
1831614882MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL al.rodriguez@pvida.net Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910002234 TX Order and Referring Only - Nurse Practitioner 5698040103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alalibo PLLC Past Accepting new patients
Carol N. Abalihi, MD, PA PastSince Sep 19, 2017 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1831614882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 PERA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052412",
            "telephone_number": "915-533-7057",
            "fax_number": "915-533-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 PERA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052412",
            "telephone_number": "915-533-7057",
            "fax_number": "915-533-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ALEXANDRA",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP134744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831614882",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "al.rodriguez@pvida.net",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3612 Pera Ave",
            "city": "El Paso",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799052412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.