Mario Ivan Rosario, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

21906 Issued in PR

Practice address

Carr # 2 KM 94.1 Bo. Yeguada
Camuy, PR 00627

Phone

(787) 356-3158

NPI assigned

Jun 11, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Corporacion de Servicios Medicos Primarios Y Prevencion de Hatillo

  • Community/Retail Pharmacy
  • Hatillo, PR
  • NPI 1659406015
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1023633468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 3 BOX 12360",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "006279814",
            "telephone_number": "787-356-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR # 2 KM 94.1 BO. YEGUADA",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "00627",
            "telephone_number": "787-356-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "MARIO",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunice Rosado
• Yiselis Rosado
• Maria Isabel Rosario Dorta
• Jonatan Rosario-Rosario, MSW
• Cristal M Rosario, LCDA
• Norma I Rosario, MA
• RR Psychological Group, PSC
• Jeremy Yesiel Ruiz Delgado
• Marchelle S Ruiz Gonzalez, PHARMD
• Gladys S Ruiz Hernandez, PT

• General Practice Physician in Camuy, PR
• Providers in Camuy, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.