Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. IVAN GABRIEL RODRIGUEZ PSYD
NPI 1396203956
Clinical Neuropsychologist in Dallas, TX

Q: What is Ivan Rodriguez's NPI number?

The NPI number for Ivan Rodriguez is 1396203956. It was assigned to this individual provider in the NPPES registry on March 3, 2019.

Q: What is Ivan Rodriguez's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Ivan Rodriguez was last updated on August 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 03, 2019PECOS Enrolled

1440 EMPIRE CENTRAL DR, DALLAS, TX 75247(214) 648-4646 Get Directions Write a Review

NPPES record last updated: August 20, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 20, 2026, Dec 13, 2022, Aug 24, 2021 and 2 more (5 updates tracked since 2019).

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About Dr. Ivan Gabriel Rodriguez Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. IVAN GABRIEL RODRIGUEZ PSYD (NPI 1396203956) is an individual clinical neuropsychologist in Dallas, Texas, licensed in Florida (PY11209) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Tampa, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1396203956

Entity TypeIndividualMale

Primary Taxonomy103G00000X

Provider Legal NameDR. IVAN GABRIEL RODRIGUEZCredential: PSYD

Location Address1440 EMPIRE CENTRAL DRDallas, TX 75247-4091

Mailing Address5323 Harry Hines BlvdDallas, TX 75390-7201

Phone(214) 648-4646

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateMarch 3, 2019

Last NPPES UpdateAugust 20, 20265 updates tracked since enumeration

NPPES CertifiedAugust 20, 2026

✔ NPI 1396203956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in FL · PY11209

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologistTaxonomy 103T00000X · License 41032 (TX)

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PY11209 (FL)

1440 EMPIRE CENTRAL DR, Dallas, TX 75247

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Secondary Practice Location 1

Location 13515 E Fletcher AveTampa, FL 33613-4706 · Phone (813) 821-8038

Other Identifiers 1

OtherA3858FL · Blue Cross Blue Shield

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ivan Gabriel Rodriguez Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153728266

PECOS Enrollment IDI20210916000103, I20260603004803

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of psychological or neuropsychological test, each additional 30 minutes 96137

This procedure involves administering psychological or neuropsychological tests to evaluate your mental functions. Each additional 30 minutes allows for a more in-depth assessment of your cognitive abilities, emotions, and behavior. It's crucial for accurate diagnosis and treatment planning.

243 services45 patients

Evaluation of neuropsychological test, each additional hour 96133

This service involves further evaluation of your neuropsychological test results beyond the initial hour. It helps to understand your cognitive functioning better, focusing on areas like memory, attention, and problem-solving skills.

102 services41 patients

Administration of psychological or neuropsychological test, first 30 minutes 96136

This procedure involves a health professional conducting a psychological or neuropsychological test. The first 30 minutes typically involve understanding your mental health or brain function through various assessments. This helps in diagnosing and treating mental health disorders effectively.

47 services45 patients

Exam of neurobehavioral status, first hour 96116

An exam of neurobehavioral status is a medical procedure that evaluates your brain's functions. This includes assessing your cognitive abilities, emotional responses, and behavioral patterns. The first hour of the exam is typically dedicated to this initial evaluation.

43 services41 patients

Evaluation of neuropsychological test, first hour 96132

An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.

41 services41 patients

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KALTRA DHIMA PHD

Clinical Neuropsychologist