Individual provider Active NPI

Evelyn Agostini Rodriguez, MD

  • Internal Medicine Physician
  • Ponce, PR
National Provider Identifier
1104934041
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12837 Issued in PR
Practice address
Urb Valle Verde
Pageo Real #1014 Suite 1
Ponce, PR 00716-3500
Phone
(787) 284-0574
Fax
(787) 284-0574
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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 12837 PR Primary

Addresses

Primary practice location

Urb Valle Verde
Pageo Real #1014 Suite 1
Ponce, PR 00716-3500

Mailing address

PO Box 76
Mercedita
Ponce, PR 00715-0076
Phone (787) 284-0574

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
I20060420000467 PR Practitioner - Internal Medicine 8022027986 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Centro IncGroup PAC ID 5890692131, 62 clinicians

Practice addresses (Care Compare)

1034 Ave Hostos
Ponce, PR 00716-1115
Phone 78784393931025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Behavioral Care Corp. Current Accepting new patients
Inspira Behavioral Care Corp CurrentSince Aug 20, 2014 Accepting new patients
Med Centro, Inc. CurrentSince Dec 6, 2023 Accepting new patients
Med Centro, Inc. CurrentSince Dec 6, 2023 Accepting new patients
Inspira Behavioral Care Corp. CurrentSince Aug 20, 2014 Accepting new patients
Med Centro, Inc. Current Accepting new patients
C & M Internal Medicine, PSC Past Accepting new patients

Locations

1034 Ave Hostos
Ponce, PR 00716
Phone (787) 242-2279

55 Calle Comercio
Yauco, PR 00698
Phone (787) 267-1810

Interoperability endpoints

  • Direct secure messaging: evelyn.agostini@medcentro.directbygreenway.com

Organizations & group practices 12

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1104934041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 76",
            "address_2": "MERCEDITA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007150076",
            "telephone_number": "787-284-0574",
            "fax_number": "787-284-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB VALLE VERDE",
            "address_2": "PAGEO REAL #1014 SUITE 1",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007163500",
            "telephone_number": "787-284-0574",
            "fax_number": "787-284-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTINI RODRIGUEZ",
        "first_name": "EVELYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.