Individual provider Active NPI

Rodolfo Enrique Nussbaum Gonzalez

  • Student in an Organized Health Care Education/Training Program
  • South Bend, IN
National Provider Identifier
1841008380
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1234 N Notre Dame Ave
South Bend, IN 46617-1404
Phone
(574) 575-6867
NPI assigned
Dec 30, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1234 N Notre Dame Ave
South Bend, IN 46617-1404

Mailing address

1234 N Notre Dame Ave
South Bend, IN 46617-1404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250630002227 MN Order and Referring Only - NeurologyPractitioner - Neurology 9234642661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1841008380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 N NOTRE DAME AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 N NOTRE DAME AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171404",
            "telephone_number": "574-575-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM GONZALEZ",
        "first_name": "RODOLFO",
        "middle_name": "ENRIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.