Active NPI
Glenda Milagros Rodriguez, MD
- General Practice Physician
- Juana Diaz, PR
National Provider Identifier
1194768150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 14919
- Practice address
- Carrion Maduro Street
#31
Juana Diaz, PR 00795 - Phone
- (787) 837-6412
- NPI assigned
- Jun 14, 2006
- Last updated
- May 2, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14919 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Med Centro, Inc. | General Practice | Current | Accepting new patients |
| Hospital Menonita Ponce Inc | General Practice | Current | Accepting new patients |
| Med Centro, Inc. | Current | Accepting new patients | |
| Med Centro, Inc. | General Practice | Current | 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
- 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.
-
dba Grupo Medico Menonita Ponce
- Specialist
- Ponce, PR
- NPI 1336859479
General Practice
-
- Federally Qualified Health Center (FQHC)
- Ponce, PR
- NPI 1669097374
-
- Specialist
- Coto Laurel, PR
- NPI 1679529648
-
dba Community Cornerstone of Puerto Rico
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Ponce, PR
- NPI 1578658647
-
dba Hospital San Cristobal
- General Acute Care Hospital
- Coto Laurel, PR
- NPI 1568476539
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.