Individual provider Active NPI

Mariella Rodriguez Rodriguez

  • Audiologist
  • Ponce, PR
National Provider Identifier
1184086027
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
670 Issued in PR
Practice address
1742 Calle Marquesa
Valle Real
Ponce, PR 00716-0515
Phone
(787) 598-3215
NPI assigned
Mar 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 670 PR Primary

Addresses

Primary practice location

1742 Calle Marquesa
Valle Real
Ponce, PR 00716-0515

Mailing address

1742 Calle Marquesa
Valle Real
Ponce, PR 00716-0505

Other identifiers 1

IdentifierTypeStateIssuer
237600000XOtherPRTAXONOMY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180322001470 PR Practitioner - Qualified Audiologist 4082991633 Reassigns benefits to 1 organization
Practice locations: Cabo Rojo, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Otologico de Puerto Rico CSP Audiologist CurrentSince Nov 20, 2016 Accepting new patients
Otologic PSC Past 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": "1458518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1184086027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1742 CALLE MARQUESA",
            "address_2": "VALLE REAL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007160505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 CALLE MARQUESA",
            "address_2": "VALLE REAL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007160515",
            "telephone_number": "787-598-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ RODRIGUEZ",
        "first_name": "MARIELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-21",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PR",
            "license": "670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "237600000X",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.