Individual provider Active NPI

Middelia Rodriguez, MD

  • Internal Medicine Physician
  • Humacao, PR
National Provider Identifier
1093734485
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10291 Issued in PR
Practice address
# 3 Boulevard del Rio
Humacao, PR 00791
Phone
(787) 737-6737
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10291 PR Primary

Addresses

Primary practice location

# 3 Boulevard del Rio
Humacao, PR 00791

Mailing address

P. O. Box 950
Gurabo, PR 00778
Phone (787) 737-6737

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170817001277 PR Practitioner - Internal Medicine 8628340270 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neomed Center, Inc CurrentSince Jul 31, 2017 Accepting new patients
Neomed Center, Inc Current Accepting new patients
Neomed Center, Inc. CurrentSince Jul 31, 2017 Accepting new patients
Neomed Center, Inc. Past Accepting new patients

Locations

130 Calle Carite
Trujillo Alto, PR 00976
Phone (787) 292-3120

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093734485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 950",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-737-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "# 3 BOULEVARD DEL RIO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-737-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MIDDELIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "10291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.