Organization Active NPI

Cardiomed One PSC

  • Cardiovascular Disease Physician
  • Rio Piedras, PR
National Provider Identifier
1104903970
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOMED ONE PSC
Practice address
1716 Calle Parana
El Cerezal
Rio Piedras, PR 00926-3148
Phone
(787) 766-2200
Fax
(787) 766-8545
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Authorized official

Name
Neftali Rodriguez
Title
Owner
Phone
(787) 766-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1716 Calle Parana
El Cerezal
Rio Piedras, PR 00926-3148

Mailing address

Felisa Rincon de Gautier
Cond Paseo Monte 1608
San Juan, PR 00926-6662
Phone (787) 766-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120329000159 PR Part B Supplier - Clinic/Group Practice 7719147719 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1104903970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FELISA RINCON DE GAUTIER",
            "address_2": "COND PASEO MONTE 1608",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266662",
            "telephone_number": "787-766-2200",
            "fax_number": "787-766-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 CALLE PARANA",
            "address_2": "EL CEREZAL",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "009263148",
            "telephone_number": "787-766-2200",
            "fax_number": "787-766-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOMED ONE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "NEFTALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-766-2200"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Piedras, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.