Individual provider Active NPI

Daisy A Rodriguez, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1891797015
Registry record updated Mar 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD045274E Issued in PA
Practice address
841 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone
(215) 425-1500
Fax
(215) 425-1659
NPI assigned
Jun 1, 2005
Reactivated
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD045274E PA Primary
Independent Medical Examiner Physician 202C00000X MD045274E PA
Internal Medicine Physician 207R00000X ME73807 FL
Internal Medicine Physician 207R00000X 9400621 NC

Addresses

Primary practice location

841 E Allegheny Ave
Philadelphia, PA 19134-2401

Mailing address

841 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone (215) 425-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080130000277 PA Practitioner - Internal Medicine 6002893583 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9400621NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
George L. Rodriguez, M.D., PC Internal Medicine Current Accepting new patients
George L Rodriguez MD PC Internal Medicine CurrentSince May 1, 2007 Accepting new patients
George L. Rodriguez, M.D., PC CurrentSince May 1, 2007 Accepting new patients
Complete Local Specialty Care, Inc Internal Medicine PastSince Sep 23, 2012 Accepting new patients
Stand Up MRI of Boca Raton Inc PastSince Jun 1, 2008 Accepting new patients

Locations

841 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 425-1500

1938 S Columbus Blvd
Philadelphia, PA 19148
Phone (215) 462-1500

7632 City Line Ave
Philadelphia, PA 19151
Phone (215) 473-1500

Organizations & group practices 5

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237507200000",
    "number": "1891797015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342401",
            "telephone_number": "215-425-1500",
            "fax_number": "215-425-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342401",
            "telephone_number": "215-425-1500",
            "fax_number": "215-425-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DAISY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2009-03-20",
        "deactivation_date": "2006-03-31",
        "reactivation_date": "2006-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD045274E",
            "primary": true
        },
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "PA",
            "license": "MD045274E",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME73807",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9400621",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.