Individual provider Active NPI

Michelle Marie Marquez Rosario, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Loiza, PR
National Provider Identifier
1063987279
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
22356 Issued in PR
Practice address
Carr 188 # 187
Loiza, PR 00772-1850
Phone
(787) 876-2042
Fax
(787) 256-1900
NPI assigned
Oct 4, 2018
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 22356 PR
Family Medicine Physician 207Q00000X 22356 PR
Family Medicine Physician 207Q00000X 34968 PR
Family Medicine Physician 207Q00000X 15245-I PR
Geriatric Medicine (Family Medicine) Physician 207QG0300X 22356 PR Primary

Addresses

Primary practice location

Carr 188 # 187
Loiza, PR 00772-1850

Mailing address

#64B Goyco Street
Caguas, PR 00725
Phone (787) 746-2530

Other practice location 1

Paseos de Degetau
Apt. 3104
Caguas, PR 00727-0072
Phone (787) 691-5293

Other identifiers 1

IdentifierTypeStateIssuer
5027105OtherPRLICENSE IDENTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15245-IPRMDFamily Medicine Physician
34968PRMDFamily Medicine Physician
22356PRMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ap Family Medical Care, CSP Family Medicine PastSince May 1, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1063987279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#64B GOYCO STREET",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-746-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 188 # 187",
            "city": "LOIZA",
            "state": "PR",
            "postal_code": "007721850",
            "telephone_number": "787-876-2042",
            "fax_number": "787-256-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Paseos de Degetau",
            "address_2": "Apt. 3104",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "007270072",
            "country_code": "US",
            "telephone_number": "787-691-5293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARQUEZ ROSARIO",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "22356",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "22356",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "34968",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "15245-I",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PR",
            "license": "22356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE IDENTIFICATION",
            "identifier": "5027105",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loiza, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.