Dr Ivan Gabriel Rodriguez, PSYD is a medicare enrolled "Clinical Neuropsychologist" provider in Tampa, Florida. He graduated from medical school in 2018 and has 6 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice University Medical Service Association Inc and his current practice location is
14499 N Dale Mabry Hwy Ste 130-s, Tampa, Florida. You can reach out to his office (for appointments etc.) via phone at
(813) 530-1414.
Dr Ivan Gabriel Rodriguez is licensed to practice in Florida (license number PY11209) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1396203956.
Healthcare Provider's Profile
| Full Name | Dr Ivan Gabriel Rodriguez |
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| Gender | Male |
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| Speciality | Clinical Psychologist |
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| Experience | 6 Years |
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| Location | 14499 N Dale Mabry Hwy Ste 130-s, Tampa, Florida |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Ivan Gabriel Rodriguez graduated from medical school in 2018
NPI Data:
- NPI Number: 1396203956
- Provider Enumeration Date: 03/03/2019
- Last Update Date: 12/13/2022
Medicare PECOS Information:
- PECOS PAC ID: 1153728266
- Enrollment ID: I20210916000103
Medical Identifiers
Medical identifiers for Dr Ivan Gabriel Rodriguez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1396203956 | NPI | - | NPPES |
| A3858 | Other | FL | BLUE CROSS BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | PY11209 (Florida) | Secondary |
| 103G00000X | Clinical Neuropsychologist | PY11209 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| University Medical Service Association Inc | 6800790221 | 583 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Ivan Gabriel Rodriguez allows following entities to bill medicare on his behalf.
| Entity Name | University Medical Service Association Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992742324
PECOS PAC ID: 6800790221
Enrollment ID: O20031126000130 |
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| Entity Name | Personal Recovery Network Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881990869
PECOS PAC ID: 5092611384
Enrollment ID: O20200416000590 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ivan Gabriel Rodriguez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Ivan Gabriel Rodriguez, PSYD
14499 N Dale Mabry Hwy Ste 130-s,
Tampa, FL 33618-2078
Ph: (813) 530-1414 | Dr Ivan Gabriel Rodriguez, PSYD
14499 N Dale Mabry Hwy Ste 130-s,
Tampa, FL 33618-2078
Ph: (813) 530-1414 |
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