Individual provider Active NPI

Gretchen Josefina Rodriguez, M.D

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1992938849
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN936 Issued in FL
Practice address
308 W Bass St
Kissimmee, FL 34741-5001
Phone
(407) 933-1760
Fax
(407) 933-8060
NPI assigned
Aug 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17411 PR
General Practice Physician 208D00000X ACN936 FL Primary

Addresses

Primary practice location

308 W Bass St
Kissimmee, FL 34741-5001

Mailing address

308 W Bass St
Kissimmee, FL 34741-5001
Phone (407) 483-8801

Other practice location 1

121 S Orange Ave Ste 940
Orlando, FL 32801-3234
Phone (407) 658-9687 ext. 129

Other practice location 2

5840 W Colonial Dr
Orlando, FL 32808-7558
Phone (407) 720-7302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170727001785 FL Practitioner - General Practice 7911153580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Primary Healthcare Associates, IncGroup PAC ID 4183606601, 16 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

308 W Bass St
Kissimmee, FL 34741-5001
Phone (407) 933-1760

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17411PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Healthcare Associates, Inc CurrentSince Feb 8, 2021 Accepting new patients
Orlando Family Physicians, LLC General Practice CurrentSince Jan 5, 2025 Accepting new patients
Idelis Fedeslinda Arias de la Torre General Practice PastSince Jun 1, 2021 Accepting new patients

Locations

308 W Bass St
Kissimmee, FL 34741
Phone (407) 483-8801

1130 S Semoran Blvd
Orlando, FL 32807
Phone (407) 382-1376

5840 W Colonial Dr
Orlando, FL 32808
Phone (407) 292-2200

121 S Orange Ave
Ste 940
Orlando, FL 32801
Phone 4076589687 ext. 129

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1992938849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 W BASS ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415001",
            "telephone_number": "407-483-8801",
            "fax_number": "407-483-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 W BASS ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415001",
            "telephone_number": "407-933-1760",
            "fax_number": "407-933-8060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 S Orange Ave Ste 940",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328013234",
            "country_code": "US",
            "telephone_number": "407-658-9687 x129",
            "fax_number": "407-286-4515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5840 W Colonial Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328087558",
            "country_code": "US",
            "telephone_number": "407-720-7302",
            "fax_number": "407-293-1355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GRETCHEN",
        "middle_name": "JOSEFINA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2023-03-07",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17411",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.