Individual provider Active NPI

Cristina Marie Rodriguez, MD

  • General Practice Physician
  • Dorado, PR
National Provider Identifier
1205504693
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23005 Issued in PR
Practice address
Urb Monte Mayor Calle Carpintero 605
Dorado, PR 00646-0064
Phone
(787) 475-6847
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 15830-I PR
General Practice Physician 208D00000X 23005 PR Primary

Addresses

Primary practice location

Urb Monte Mayor Calle Carpintero 605
Dorado, PR 00646-0064

Mailing address

HC 6 Box 61284
Camuy, PR 00627-9058
Phone (787) 475-6847

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
I20230621000782 PR Practitioner - General Practice 0941668271 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15830-IPRMDGeneral Practice Physician
23005PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J.W. Goveo P.S.C. Medical Services PastSince Sep 1, 2021 Accepting new patients

Organizations & group practices 1

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": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1205504693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 6 BOX 61284",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "006279058",
            "telephone_number": "787-475-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB MONTE MAYOR CALLE CARPINTERO 605",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006460064",
            "telephone_number": "787-475-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CRISTINA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15830-I",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

Verify at the official NPI Registry.