Individual provider Active NPI

Juan Rodriguez, R.N.

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1952771834
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307550-1 Issued in NY
Practice address
630 W 168TH St
New York, NY 10032-3725
Phone
(212) 305-6204
NPI assigned
Oct 5, 2015
Last updated
Feb 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F307550-1 NY Primary
Registered Nurse 163W00000X 26NR14136100 NJ
Emergency Registered Nurse 163WE0003X 619839-1 NY

Addresses

Primary practice location

630 W 168TH St
New York, NY 10032-3725

Mailing address

306 1St St
Apt.2
Westfield, NJ 07090-3318
Phone (732) 423-1011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20200221000027 NJ Practitioner - Nurse Practitioner 6305145467 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK BergenGroup PAC ID 1456614114, 254 clinicians
MSK MonmouthGroup PAC ID 1153619291, 300 clinicians

Practice addresses (Care Compare)

136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Phone (908) 542-3000

225 Summit Ave
Montvale, NJ 07645-1523
Phone (908) 542-3336

480 Red Hill Rd
Middletown, NJ 07748-3052
Phone (908) 542-3007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.57 of 100Reported as group
Quality
72.31
Improvement activities
40
Cost
76.55

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
80.94
Improvement activities
40
Cost
65.19

Merit-based Incentive Payment System (MIPS)

Final score
80.37 of 100Reported as group
Quality
71.5
Improvement activities
40
Cost
70.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR14136100NJMDRegistered Nurse
619839-1NYMDEmergency Registered Nurse
F307550-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey CurrentSince Jan 6, 2020 Accepting new patients
MSK Bergen CurrentSince Jan 6, 2020 Accepting new patients
MSK Monmouth CurrentSince Jan 6, 2020 Accepting new patients

Locations

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jrodriguez21682@mskcc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1952771834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 1ST ST",
            "address_2": "APT.2",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070903318",
            "telephone_number": "732-423-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JUAN",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-05",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307550-1",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR14136100",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NY",
            "license": "619839-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.