MEDICARE: LUIS B RODRIGUEZ CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	APRN11025817	FL
2	163W00000X	Registered Nurse	14-151453-011	KS
3	367500000X	Certified Registered Nurse Anesthetist	212552	OK
4	367500000X	Certified Registered Nurse Anesthetist	43-557766-011	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3821024000	OTHER	PA	IND. BLUE CROSS
2	1594393	OTHER	PA	GATEWAY
3	2571791	OTHER	PA	FIRST PRIORITY
4	12186828	OTHER	PA	CAQH
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	146167	OTHER	PA	GEISINGER
7	2571791	OTHER	PA	HIGHMARK
8	50097984	OTHER	PA	CAPITAL ADVANTGE
9	9685655	OTHER	PA	AETNA

General Provider Information

NPI Number	:	1053615526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS B RODRIGUEZ CRNA

Provider Business Mailing Address
First Line	:	823 N 3RD ST
Second Line	:
City	:	ARKANSAS CITY
State	:	KS
Zip	:	67005-1549
Country	:	US
Telephone Number	:	610-703-8695
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 N 3RD ST
Second Line	:
City	:	ARKANSAS CITY
State	:	KS
Zip	:	67005-1549
Country	:	US
Telephone Number	:	610-703-8695
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2010
Last Update Date	:	01/14/2026

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