Individual provider Active NPI

Sandra Elizabeth Rodriguez

  • Family Nurse Practitioner
  • San Angelo, TX
National Provider Identifier
1992577142
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1139921 Issued in TX
Practice address
2029 W Beauregard Ave
San Angelo, TX 76901-3812
Phone
(325) 658-5339
NPI assigned
Oct 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1139921 TX Primary

Addresses

Primary practice location

2029 W Beauregard Ave
San Angelo, TX 76901-3812

Mailing address

3143 Pronghorn Path
San Angelo, TX 76901-1284
Phone (325) 374-6573

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
I20240325003373 TX Practitioner - Nurse Practitioner 8123465218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Esperanza Clinic IncGroup PAC ID 7416942933, 13 clinicians

Practice addresses (Care Compare)

1610 S Chadbourne St
San Angelo, TX 76903-8510
Phone (325) 658-5339

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1139921TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Esperanza Clinic Inc Current Accepting new patients
La Esperanza Clinic, Inc. CurrentSince Jan 10, 2024 Accepting new patients

Locations

1610 S Chadbourne St
San Angelo, TX 76903
Phone (325) 658-5339

2029 W Beauregard Ave
San Angelo, TX 76901
Phone (325) 658-5339

35 E 31st St
Ste 1
San Angelo, TX 76903

35 E 31st St
San Angelo, TX 76903
Phone (325) 658-5339

34 Buick St
San Angelo, TX 76901
Phone (325) 658-5339

Interoperability endpoints

  • Direct secure messaging: srodriguez53386@shannonhealth.direct-ci.com

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.

Hospital & facility affiliations 1

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": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1992577142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3143 PRONGHORN PATH",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769011284",
            "telephone_number": "325-374-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 W BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013812",
            "telephone_number": "325-658-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "SANDRA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1139921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.