Individual provider Active NPI

Jose R Santiago Rodriguez, MD

  • Sports Medicine (Emergency Medicine) Physician
  • Cayey, PR
National Provider Identifier
1184992265
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
ME126007 Issued in FL
Practice address
186 Roberto Diaz Quintas Las Muesas
Cayey, PR 00736
Phone
(787) 263-8754
NPI assigned
Dec 5, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X ME126007 FL
Sports Medicine (Emergency Medicine) Physician 207PS0010X ME126007 FL Primary

Addresses

Primary practice location

186 Roberto Diaz Quintas Las Muesas
Cayey, PR 00736

Mailing address

186 Roberto Diaz Quintas Las Muesas
Caye, PR 00736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180802000026 FL Practitioner - Pain Management 5395023956

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME126007FLMDSports Medicine (Emergency Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1184992265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 ROBERTO DIAZ QUINTAS LAS MUESAS",
            "city": "CAYE",
            "state": "PR",
            "postal_code": "00736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 ROBERTO DIAZ QUINTAS LAS MUESAS",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "00736",
            "telephone_number": "787-263-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-05",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME126007",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME126007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayey, PR

Sources for this page

Verify at the official NPI Registry.