Individual provider Active NPI

Roalba Cotto Rodriguez, M.D.

  • General Practice Physician
  • Cidra, PR
National Provider Identifier
1174633267
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9720 Issued in PR
Practice address
406 Miramelinda
Sabanera
Cidra, PR 00739
Phone
(787) 754-4244
Fax
(787) 739-9663
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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 9720 PR Primary

Addresses

Primary practice location

406 Miramelinda
Sabanera
Cidra, PR 00739

Mailing address

406 Miramelinda
Sabanera
Cidra, PR 00739
Phone (787) 599-1843

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
I20050625000002 PR Practitioner - Pediatric MedicinePractitioner - General Practice 9436194875 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9720PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Departamento de Salud Oficial CurrentSince Aug 20, 2024 Accepting new patients
Departamento de Salud Oficial CurrentSince Aug 20, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1174633267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 MIRAMELINDA",
            "address_2": "SABANERA",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "00739",
            "telephone_number": "787-599-1843",
            "fax_number": "787-739-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 MIRAMELINDA",
            "address_2": "SABANERA",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "00739",
            "telephone_number": "787-754-4244",
            "fax_number": "787-739-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTO RODRIGUEZ",
        "first_name": "ROALBA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cidra, PR

Sources for this page

Verify at the official NPI Registry.