Individual provider Active NPI

Whitney Elizabeth Rodriguez, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1952709040
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09425 Issued in TX
Practice address
1411 N Beckley Ave
Pavilion III, Suite 268
Dallas, TX 75203-1259
Phone
(214) 947-4400
Fax
(214) 947-4404
NPI assigned
Dec 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09425 TX Primary

Addresses

Primary practice location

1411 N Beckley Ave
Pavilion III, Suite 268
Dallas, TX 75203-1259

Mailing address

1411 N Beckley Ave
Pavilion III, Suite 268
Dallas, TX 75203-1259
Phone (214) 947-4400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170316001021 TX Practitioner - Physician Assistant 4688959539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

1441 N Beckley Ave
Dallas, TX 75203-1201
Phone (214) 833-3478

3000 Blackburn St
Suite 130
Dallas, TX 75204-2217
Phone (214) 599-8624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Feb 5, 2017 Accepting new patients
Medhealth CurrentSince Feb 5, 2017 Accepting new patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients

Locations

1411 N Beckley Ave
Ste 268
Dallas, TX 75203

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

613 S Highway 78
Wylie, TX 75098
Phone (972) 941-8700

Interoperability endpoints

  • Direct secure messaging: wsmith10881@dm.mhd.com

Organizations & group practices 4

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": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1952709040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE",
            "address_2": "PAVILION III, SUITE 268",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031259",
            "telephone_number": "214-947-4400",
            "fax_number": "214-947-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE",
            "address_2": "PAVILION III, SUITE 268",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031259",
            "telephone_number": "214-947-4400",
            "fax_number": "214-947-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "WHITNEY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-05",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.