Individual provider Active NPI

Roberto Almodovar Olmeda, MD

  • General Practice Physician
  • San German, PR
National Provider Identifier
1114009065
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
13977 Issued in PR
Practice address
9 Calle Esperanza
San German, PR 00683-3903
Phone
(787) 892-6226
Fax
(787) 892-6226
NPI assigned
Oct 19, 2006
Last updated
Sep 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 13977 PR Primary

Addresses

Primary practice location

9 Calle Esperanza
San German, PR 00683-3903

Mailing address

HC 9 Box 4492
Sabana Grande, PR 00637-9448
Phone (787) 892-6226

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
I20110302000186 PR Practitioner - General Practice 5698956233 Practice locations: San German, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Calle Lorenza Ramirez de Are
San German, PR 00683
Phone (787) 892-6226

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Health Corp. Past Accepting new patients
Southwest Health Corp Hospital Metropolitano San German PastSince Jul 5, 2020 Accepting new patients

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1114009065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 9 BOX 4492",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "006379448",
            "telephone_number": "787-892-6226",
            "fax_number": "787-892-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CALLE ESPERANZA",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006833903",
            "telephone_number": "787-892-6226",
            "fax_number": "787-892-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALMODOVAR OLMEDA",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "13977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

Verify at the official NPI Registry.