Individual provider Active NPI

Andres Javier Rosado Matos

  • Student in an Organized Health Care Education/Training Program
  • Bayamon, PR
National Provider Identifier
1114655271
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Riverside Park, Calle 7 F23
Bayamon, PR 00961
Phone
(787) 405-0097
NPI assigned
Aug 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Riverside Park, Calle 7 F23
Bayamon, PR 00961

Mailing address

Riverside Park, Calle 7 F23
Bayamon, PR 00961
Phone (787) 405-0097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20240701003721 LA Order and Referring Only - AnesthesiologyPractitioner - Anesthesiology 4385188366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1114655271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RIVERSIDE PARK, CALLE 7 F23",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-405-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RIVERSIDE PARK, CALLE 7 F23",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-405-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO MATOS",
        "first_name": "ANDRES",
        "middle_name": "JAVIER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-08",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.