Individual provider Active NPI

Rogelio Efren Rodriguez, ARNP

  • Gerontology Nurse Practitioner
  • Lauderdale Lakes, FL
National Provider Identifier
1902357775
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
9408018 Issued in FL
Practice address
4850 W Oakland Park Blvd Ste 136
Lauderdale Lakes, FL 33313-7277
Phone
(844) 665-4827
Fax
(877) 762-0841
NPI assigned
Oct 17, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 9408018 FL Primary

Addresses

Primary practice location

4850 W Oakland Park Blvd Ste 136
Lauderdale Lakes, FL 33313-7277

Mailing address

2000 NW 87TH Ave # 101-102
Doral, FL 33172-2654
Phone (844) 665-4827

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
I20171006001049 FL Practitioner - Nurse Practitioner 9436424082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guidewell Sanitas I, LLCGroup PAC ID 9537447107, 124 clinicians

Practice addresses (Care Compare)

180 SW 84TH Ave
Plantation, FL 33324-2731
Phone (844) 665-4827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9408018FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Guidewell Sanitas I, LLC CurrentSince Jun 18, 2018 Accepting new patients

Locations

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

4850 W Oakland Park Blvd
Ste 136
Lauderdale Lakes, FL 33313
Phone (954) 739-4420

180 SW 84th Ave
Plantation, FL 33324
Phone (954) 271-2855

Interoperability endpoints

  • Direct secure messaging: rogelio.rodriguez@wwmp.eclinicaldirectplus.com

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1902357775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NW 87TH AVE # 101-102",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722654",
            "telephone_number": "844-665-4827",
            "fax_number": "877-762-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 136",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137277",
            "telephone_number": "844-665-4827",
            "fax_number": "877-762-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ROGELIO",
        "middle_name": "EFREN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "9408018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.