Individual provider Active NPI

Nicolas Rosario Matos, M.D.

  • Pediatrics Physician
  • Bayamon, PR
National Provider Identifier
1184827230
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
17587 Issued in PR
Practice address
Edif Plaza San Pablo 1, Suite 102
Paseo San Pablo
Bayamon, PR 00961-7018
Phone
(787) 709-4165
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 17587 PR Primary

Addresses

Primary practice location

Edif Plaza San Pablo 1, Suite 102
Paseo San Pablo
Bayamon, PR 00961-7018

Mailing address

86 Calle Anis
Urb. Ciudad Jardin
Canovanas, PR 00729-9827
Phone (787) 505-2001

Other practice location 1

Hospital San Juan
Barrio Monacillo
Rio Piedras, PR 00936
Phone (787) 766-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17587PRMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1184827230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 CALLE ANIS",
            "address_2": "URB. CIUDAD JARDIN",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007299827",
            "telephone_number": "787-505-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDIF PLAZA SAN PABLO 1, SUITE 102",
            "address_2": "PASEO SAN PABLO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617018",
            "telephone_number": "787-709-4165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Hospital San Juan",
            "address_2": "Barrio Monacillo",
            "address_purpose": "LOCATION",
            "city": "Rio Piedras",
            "state": "PR",
            "postal_code": "00936",
            "country_code": "US",
            "telephone_number": "787-766-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSARIO MATOS",
        "first_name": "NICOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "17587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.