Individual provider Active NPI

Glenda Milagros Rodriguez, MD

  • General Practice Physician
  • Juana Diaz, PR
National Provider Identifier
1194768150
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14919 Issued in PR
Practice address
Carrion Maduro Street
#31
Juana Diaz, PR 00795
Phone
(787) 837-6412
NPI assigned
Jun 14, 2006
Last updated
May 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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 14919 PR Primary

Addresses

Primary practice location

Carrion Maduro Street
#31
Juana Diaz, PR 00795

Mailing address

81 Calle 4
Juana Diaz, PR 00795-1513
Phone (787) 299-7981

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
I20050927000761 PR Practitioner - General Practice 2062447279 Reassigns benefits to 2 organizations
Practice locations: Humacao, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14919PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Med Centro, Inc. General Practice Current Accepting new patients
Hospital Menonita Ponce Inc General Practice CurrentSince Oct 13, 2024 Accepting new patients
Med Centro, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Med Centro, Inc. General Practice CurrentSince Oct 1, 2018 Accepting new patients
Quality Health Services of Puerto Rico Inc Past Accepting new patients
Community Cornerstones Inc Past Accepting new patients
Centro Medico Central Coto Laurel, Inc Past Accepting new patients

Locations

1034 Ave Hostos
Ponce, PR 00716
Phone (787) 242-2279

Interoperability endpoints

  • Direct secure messaging: glenda.rodriguez@medcentro.directbygreenway.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1194768150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 CALLE 4",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007951513",
            "telephone_number": "787-299-7981",
            "fax_number": "787-837-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRION MADURO STREET",
            "address_2": "#31",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "00795",
            "telephone_number": "787-837-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GLENDA",
        "middle_name": "MILAGROS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juana Diaz, PR

Sources for this page

Verify at the official NPI Registry.