Individual provider Active NPI

Jose Javier Rodriguez Fontanez, M.D

  • Emergency Medical Services (Emergency Medicine) Physician
  • Guayama, PR
National Provider Identifier
1104812122
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
6590 Issued in PR
Practice address
Ave Pedro Albizu Campos
Guayama, PR 00785
Phone
(787) 864-5953
Fax
(787) 864-5953
NPI assigned
Sep 26, 2005
Last updated
Jul 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 6590 PR Primary

Addresses

Primary practice location

Ave Pedro Albizu Campos
Guayama, PR 00785

Mailing address

Ave. Pedro Albizu Campos
Box 2866
Guayama, PR 00785-2866
Phone (787) 864-5953

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
I20140403002057 PR Practitioner - Emergency MedicinePractitioner - General Practice 5395806202 Reassigns benefits to 1 organization
Practice locations: Guayama, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6590PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud Familiar Dr. Julio Palmieri Ferri Inc. Current Accepting new patients
Centro de Salud Familiar Dr. Julio Palmieri Ferri Inc. CurrentSince Jan 23, 2014 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Centro de Salud Familiar Dr. Julio Palmieri Ferri Inc.Arroyo, PR, CCN 401803 Federally qualified health center Corporate Director Jul 11, 2005

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1104812122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVE. PEDRO ALBIZU CAMPOS",
            "address_2": "BOX 2866",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "007852866",
            "telephone_number": "787-864-5953",
            "fax_number": "787-864-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE PEDRO ALBIZU CAMPOS",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00785",
            "telephone_number": "787-864-5953",
            "fax_number": "787-864-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ FONTANEZ",
        "first_name": "JOSE",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "PR",
            "license": "6590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guayama, PR

Sources for this page

Verify at the official NPI Registry.