Individual provider Active NPI

Jorge Evaldo Rodriguez Nylund

  • Interventional Cardiology Physician
  • San Diego, CA
National Provider Identifier
1881153757
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A201148 Issued in CA
Practice address
8707 Complex Dr
San Diego, CA 92123-1401
Phone
(619) 439-2464
NPI assigned
Mar 19, 2019
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 69418 AZ
Interventional Cardiology Physician 207RI0011X A201148 CA Primary

Addresses

Primary practice location

8707 Complex Dr
San Diego, CA 92123-1401

Mailing address

8707 Complex Dr
San Diego, CA 92123-1401
Phone (619) 616-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230524001212 AZ Practitioner - Internal Medicine 6507222163 Reassigns benefits to 1 organization
I20260504005288 CA Practitioner - Interventional Cardiology 6507222163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8787 Complex Dr
Suite 210
San Diego, CA 92123-1419

9001 Markville Dr Apt
Suite 1213
Dallas, TX 75243-9378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
69418AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dvma, LLC Internal Medicine CurrentSince Nov 1, 2024 Accepting new patients
VHS Acquisition Subsidiary Number 1 Inc Past Accepting new patients

Locations

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

13350 N 94th Dr
Ste A101
Peoria, AZ 85381
Phone (623) 933-1010

1930 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 532-1000

Interoperability endpoints

  • Direct secure messaging: jorge.rodriguez@297228672368644.direct.elationemr.com

Organizations & group practices 3

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1881153757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8707 COMPLEX DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231401",
            "telephone_number": "619-616-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8707 COMPLEX DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231401",
            "telephone_number": "619-439-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ NYLUND",
        "first_name": "JORGE",
        "middle_name": "EVALDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "69418",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A201148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.