Individual provider Active NPI

Jesus N Rodriguez Angulo, MD

  • Pediatrics Physician
  • Homestead, FL
National Provider Identifier
1912930744
Registry record updated Nov 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME50088 Issued in FL
Practice address
45 NW 8TH St Ste 110
Homestead, FL 33030-4452
Phone
(305) 248-1900
Fax
(305) 248-1902
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X ME50088 FL
Pediatrics Physician 208000000X ME50088 FL Primary

Addresses

Primary practice location

45 NW 8TH St Ste 110
Homestead, FL 33030-4452

Mailing address

10980 SW 25TH St
Miami, FL 33165
Phone (305) 310-1648

Other practice location 1

240 Crandon Blvd Ste 212
Key Biscayne, FL 33149-1597
Phone (305) 361-6232

Other identifiers 1

IdentifierTypeStateIssuer
047411800MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120606000495 FL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 1759545528 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME50088FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Miami Criticare Inc. CurrentSince May 1, 2012 Accepting new patients
Ramon a Guevara D.O.,P.a. Pediatrics Past Accepting new patients
Ramon a Guevara D.O.,P.a. PastSince Feb 24, 2022 Accepting new patients

Locations

6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731715200000",
    "number": "1912930744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10980 SW 25TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33165",
            "telephone_number": "305-310-1648",
            "fax_number": "304-220-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 NW 8TH ST STE 110",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304452",
            "telephone_number": "305-248-1900",
            "fax_number": "305-248-1902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Crandon Blvd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Key Biscayne",
            "state": "FL",
            "postal_code": "331491597",
            "country_code": "US",
            "telephone_number": "305-361-6232",
            "fax_number": "305-365-0031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ ANGULO",
        "first_name": "JESUS",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-11-16",
        "certification_date": "2024-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME50088",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME50088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047411800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.