MR. RODOLFO A NAZARIO MD
NPI 1730174111
General Practice in Middletown, NY

Active since September 13, 2005PECOS EnrolledCLIA 33D2050859 · Waiver
129 WICKHAM AVE, MIDDLETOWN, NY 10940(845) 343-6461(845) 343-7613 Get Directions Write a Review

NPPES record last updated: November 13, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Rodolfo A Nazario Md NPPES

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

MR. RODOLFO A NAZARIO MD (NPI 1730174111) is an individual general practice provider in Middletown, New York, licensed in New York (191800) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through December 6, 2026, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1730174111
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameMR. RODOLFO A NAZARIOCredential: MD
Location Address129 WICKHAM AVEMiddletown, NY 10940-3714
Mailing AddressPo Box 3006Middletown, NY 10940-0466 · (845) 343-6461 · Fax (845) 343-7613
Fax(845) 343-7613
Sole ProprietorYes
Medical School CMSOtherGraduated 1982
Enumeration DateSeptember 13, 2005
Last NPPES UpdateNovember 13, 2018
NPI 1730174111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License Licensed in NY · 191800
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

129 WICKHAM AVE, Middletown, NY 10940

Other Identifiers 1

Medicaid01642319NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mr. Rodolfo A Nazario Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173845575
PECOS Enrollment IDI20141212001124
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2050859

Rodolfo A Nazario MD · Middletown, NY
Active · expires Dec 6, 2026
CLIA Number33D2050859
Laboratory TypePhysician Office
Certificate Effective DateDecember 7, 2024
Certificate Expiration DateDecember 6, 2026
Laboratory DirectorDr. Rodolfo A. Nazario-Blas
Laboratory Phone(845) 343-6461
Laboratory LocationRodolfo A Nazario MD129 Wickham Avenue, Middletown, NY 10940
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Psychiatry & Neurology (Psychiatry)
129 WICKHAM AVE
MIDDLETOWN, NY 10940
Psychiatry & Neurology (Psychiatry)
129 WICKHAM AVE
MIDDLETOWN, NY 10940

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rodolfo Nazario's NPI number?

The NPI number for Rodolfo Nazario is 1730174111. It was assigned to this individual provider in the NPPES registry on September 13, 2005.

Where is Rodolfo Nazario located?

Rodolfo Nazario practices at 129 Wickham Ave, Middletown, NY 10940. The listed phone number is (845) 343-6461.

What is Rodolfo Nazario's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Rodolfo Nazario enrolled in Medicare?

Yes. Rodolfo Nazario is registered in the Medicare PECOS enrollment system.

Does Rodolfo Nazario hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2050859) is associated with this NPI, valid through December 6, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Rodolfo Nazario was last updated on November 13, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.