Individual provider Active NPI

Enrique Juan Rodriguez-Olaverri, MD

  • Neurology Physician
  • San Juan, PR
National Provider Identifier
1104929751
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
10572 Issued in PR
Practice address
Mayaguez CT # 52
Urb.Perez Morris
San Juan, PR 00917-5130
Phone
(787) 764-0473
Fax
(787) 764-0482
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 10572 PR Primary

Addresses

Primary practice location

Mayaguez CT # 52
Urb.Perez Morris
San Juan, PR 00917-5130

Mailing address

Mayaguez CT # 52
Urb.Perez Morris
San Juan, PR 00919-5130
Phone (787) 764-0473

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
I20050208000770 PR Practitioner - Neurology 2365493236 Reassigns benefits to 4 organizations
Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advance Cardiovascular Studies, PSCGroup PAC ID 5395781942, 2 clinicians

Practice addresses (Care Compare)

Calle Cesar Gonzales 504 Hato Rey
San Juan, PR 00918
Phone (787) 221-8161

Hima San Pablo Carr
844 KM 0.5 Cupey Bajo
San Juan, PR 00928
Phone (787) 764-0473

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10572PRMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prevention Diagnostics Center Inc CurrentSince Mar 9, 2024 Accepting new patients
Advance Cardiovascular Studies, PSC CurrentSince Mar 1, 2016 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Oct 19, 2015 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Oct 19, 2015 Accepting new patients
Centro Especializado En Dolor de Cabeza Y Neurologia G S P Neurology Past Accepting new patients
Centro Especializado En Neurofisiatria Neurology Past Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

Organizations & group practices 7

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1104929751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MAYAGUEZ CT # 52",
            "address_2": "URB.PEREZ MORRIS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009195130",
            "telephone_number": "787-764-0473",
            "fax_number": "787-764-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAYAGUEZ CT # 52",
            "address_2": "URB.PEREZ MORRIS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175130",
            "telephone_number": "787-764-0473",
            "fax_number": "787-764-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-OLAVERRI",
        "first_name": "ENRIQUE",
        "middle_name": "JUAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PR",
            "license": "10572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.