Individual provider Active NPI

Juancy Jose Rodriguez, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1861798779
Registry record updated Feb 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336593-1 Issued in NY
Practice address
356 W 18TH St
New York, NY 10011-4401
Phone
(212) 271-7200
Fax
(212) 271-8114
NPI assigned
Feb 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2011

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 F336593-1 NY Primary

Addresses

Primary practice location

356 W 18TH St
New York, NY 10011-4401

Mailing address

356 W 18TH St
New York, NY 10011-4401
Phone (212) 271-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150115000968 NY Order and Referring Only - Nurse Practitioner 8325362650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F336593-1NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297296000000",
    "number": "1861798779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 W 18TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114401",
            "telephone_number": "212-271-7200",
            "fax_number": "212-271-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 W 18TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114401",
            "telephone_number": "212-271-7200",
            "fax_number": "212-271-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JUANCY",
        "middle_name": "JOSE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-10",
        "last_updated": "2011-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336593-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.