Individual provider Active NPI

Idalmis M Rodriguez, ARNP

  • Registered Nurse
  • Kissimmee, FL
National Provider Identifier
1841264728
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9209256 Issued in FL
Practice address
805 E Oak St
Kissimmee, FL 34744-4576
Phone
(407) 933-0021
Fax
(407) 933-1490
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9209256 FL Primary
Women's Health Nurse Practitioner 363LW0102X ARNP9209256 FL

Addresses

Primary practice location

805 E Oak St
Kissimmee, FL 34744-4576

Mailing address

805 E Oak St
Kissimmee, FL 34744-4576
Phone (407) 933-0021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130605000253 FL Practitioner - Nurse Practitioner 6305084294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alex Rojas MD LLCGroup PAC ID 4587725031, 4 clinicians

Practice addresses (Care Compare)

805 E Oak St
Suite 1
Kissimmee, FL 34744-4576
Phone (407) 933-0021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9209256FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Alex Rojas, M.D.,LLC CurrentSince May 25, 2013 Accepting new patients

Locations

805 E Oak St
Ste 1
Kissimmee, FL 34744
Phone (407) 933-0021

4151 Hunters Park Ln
Ste 116
Orlando, FL 32837
Phone (407) 483-0672

15820 Shaddock Dr
Ste 140
Winter Garden, FL 34787
Phone (407) 933-0021

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1841264728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444576",
            "telephone_number": "407-933-0021",
            "fax_number": "407-933-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444576",
            "telephone_number": "407-933-0021",
            "fax_number": "407-933-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "IDALMIS",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9209256",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "ARNP9209256",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.