Individual provider Active NPI

Homero Rodriguez, M.D.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1932281078
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D8413 Issued in TX
Practice address
147 W Sunset Rd Ste 201
San Antonio, TX 78209-2632
Phone
(210) 656-3900
Fax
(210) 564-0318
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D8413 TX Primary

Addresses

Primary practice location

147 W Sunset Rd Ste 201
San Antonio, TX 78209-2632

Mailing address

147 W Sunset Rd Ste 201
San Antonio, TX 78209-2632
Phone (210) 656-3900

Other identifiers 2

IdentifierTypeStateIssuer
035572901MedicaidTX
D8413OtherTXTEXAS STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180420001702 TX Order and Referring Only - Family PracticePractitioner - Family Practice 6507991569

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D8413TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hansen Health Solutions PLLC Family Medicine PastSince Jul 11, 2017 Accepting new patients

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, 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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1932281078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 W SUNSET RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782092632",
            "telephone_number": "210-656-3900",
            "fax_number": "210-564-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 W SUNSET RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782092632",
            "telephone_number": "210-656-3900",
            "fax_number": "210-564-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "HOMERO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D8413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035572901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE LICENSE",
            "identifier": "D8413",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.