Raul Edgardo Hernandez Rodriguez, MD
Individual provider Active NPI General Practice Physician · Juncos, PR
NPI 1104804749 · NPPES record last updated Nov 24, 2020
Key facts
- NPI
- 1104804749
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 5915 (PR)
- Practice address
- 58 Calle Algarin
Juncos, PR 00777-3542 - Phone
- (787) 734-8440
- Fax
- (787) 734-8440
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
58 Calle Algarin
Juncos, PR 00777-3542
Phone (787) 734-8440
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110225000086 | PR | Practitioner - General Practice | 9032390927 | Practice locations: Juncos, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 5915 | PR | Yes |
Addresses
Primary practice location
58 Calle Algarin
Juncos, PR 00777-3542
Mailing address
58 Calle Algarin
Juncos, PR 00777-3542
Phone (787) 734-8440
Other providers in Juncos, PR
- Genoves Gutierrez
- Selenia Guzman
- Healthcare Administration Solutions
- Atalia Hernandez Carrasquillo
- Jennifer Hernandez Rivera
- Gabriela Idalia Hernandez
- Maria Hernandez
- Shaira Hernandez
- Instituto de Fisiatria Y Medicina Deportiva del Este, Inc
- Integral Wellness
All providers in Juncos, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.