Individual provider Active NPI

Melissa Rodriguez, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1841012648
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1179133 Issued in TX
Practice address
903 SW 24TH St
San Antonio, TX 78207-5136
Phone
(210) 432-7801
NPI assigned
Oct 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 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 1179133 TX Primary

Addresses

Primary practice location

903 SW 24TH St
San Antonio, TX 78207-5136

Mailing address

14943 Dancers Image
San Antonio, TX 78248-0932
Phone (210) 323-8999

Other practice location 1

21 Spurs Ln
San Antonio, TX 78240-1669
Phone (210) 615-8003

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
I20241126004227 TX Practitioner - Nurse Practitioner 7911432026 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
Spurs Lane Medical Associates PAGroup PAC ID 4587826268, 4 clinicians

Practice addresses (Care Compare)

903 SW 24TH St
Medadvantage Primary Care
San Antonio, TX 78027-5136
Phone (210) 432-7801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1179133TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spurs Lane Medical Associates PA CurrentSince Nov 25, 2024 Accepting new patients

Locations

903 SW 24th St
San Antonio, TX 78207
Phone (210) 432-7801

21 Spurs Ln
Ste 260
San Antonio, TX 78240
Phone (210) 257-0705

Organizations & group practices 1

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": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1841012648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14943 DANCERS IMAGE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782480932",
            "telephone_number": "210-323-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 SW 24TH ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075136",
            "telephone_number": "210-432-7801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Spurs Ln",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782401669",
            "country_code": "US",
            "telephone_number": "210-615-8003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MELISSA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1179133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.