NPIMap

Organization Active NPI

Paul a Rodriguez DO PA

  • Specialist
  • Lighthouse Point, FL
National Provider Identifier
1881603900
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OS7048 Issued in FL
Legal business name
PAUL A RODRIGUEZ DO PA
Doing business as
VIP PAIN MEDICINE LLC
Practice address
1821 NE 25TH St
Suite 100
Lighthouse Point, FL 33064-7744
Phone
(954) 941-0484
Fax
(954) 941-0485
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Paul A Rodriguez, D.O., P.A.NPI 1629057914
Title
Director, President,Secretary,Treas
Phone
(954) 941-0484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X OS7048 FL Primary

Addresses

Primary practice location

1821 NE 25TH St
Suite 100
Lighthouse Point, FL 33064-7744

Mailing address

1821 NE 25TH Street
Suite 100
Lighthouse Point, FL 33064
Phone (954) 941-0484

Other identifiers 5

IdentifierTypeStateIssuer
285366OtherFLAVMED
DQ2139OtherFLRAILROAD MEDICARE
L4QH7OtherFLFLORIDA BLUE
49427OtherFLBCBS
257541800MedicaidFL

Other names 1

  • VIP PAIN MEDICINE LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080213000702 FL Part B Supplier - Clinic/Group Practice 9436256823 Receives reassigned benefits from 1 practitioner
Practice locations: Lighthouse Point, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1881603900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 NE 25TH STREET",
            "address_2": "SUITE 100",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "33064",
            "telephone_number": "954-941-0484",
            "fax_number": "954-941-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 NE 25TH ST",
            "address_2": "SUITE 100",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647744",
            "telephone_number": "954-941-0484",
            "fax_number": "954-941-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL A RODRIGUEZ DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR, PRESIDENT,SECRETARY,TREAS",
        "authorized_official_telephone_number": "954-941-0484",
        "authorized_official_credential": "D.O., P.A."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "OS7048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "285366",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DQ2139",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "L4QH7",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "49427",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257541800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIP PAIN MEDICINE LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lighthouse Point, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.