Individual provider Active NPI

Mayra Rodriguez, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1972890242
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
262874 Issued in NY
Practice address
1317 Castle Hill Ave
Bronx, NY 10462-4806
Phone
(718) 765-6343
NPI assigned
Jul 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 262874 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1317 Castle Hill Ave
Bronx, NY 10462-4806

Mailing address

PO Box 746087
Atlanta, GA 30374-6087
Phone (312) 733-9730

Other practice location 1

1776 Eastchester Rd
PD Unit - 2nd floor
Bronx, NY 10461-2341
Phone (718) 405-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150601001400 NY Practitioner - Internal MedicinePractitioner - Nephrology 3173844347
I20180507002105 ID Practitioner - Nephrology 3173844347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Albert Einstein College of Medicine of Yeshiva University, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 Clock Towe CMNS
Brewster, NY 10509-4055

1776 Eastchester Rd
PD Unit 2ND FL
Bronx, NY 10461-2341

3198 Grand Concourse
3Rd Floor
Bronx, NY 10458-1000

550 Mamaroneck Ave
Suite 302
Harrison, NY 10528-1616

PO Box
Suite 746087
Atlanta, GA 30374-6087

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC CurrentSince Apr 26, 2018 Accepting new patients
Mountain View Hospital LLC CurrentSince Apr 26, 2018 Accepting new patients

Locations

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

Organizations & group practices 2

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1972890242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 CASTLE HILL AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104624806",
            "telephone_number": "718-765-6343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1776 Eastchester Rd",
            "address_2": "PD Unit - 2nd floor",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104612341",
            "country_code": "US",
            "telephone_number": "718-405-8040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MAYRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "262874",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.