Individual provider Active NPI

Maribel Noble Rodriguez, MD

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1205805876
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14650 Issued in PR
Practice address
Emergency Room Pana Hospital
San Juan, PR 00910
Phone
(787) 727-0101
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14650 PR Primary

Addresses

Primary practice location

Emergency Room Pana Hospital
San Juan, PR 00910

Mailing address

Lizzie Grahm HG 12 Seventh Heha Lwittian Likes
Toa Bzi PR
Toa Bzi, PR 00949
Phone (787) 261-2417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160629002282 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6608882501

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14650PRMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CRM Group Practice Past 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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1205805876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LIZZIE GRAHM HG 12 SEVENTH HEHA LWITTIAN LIKES",
            "address_2": "TOA BZI PR",
            "city": "TOA BZI",
            "state": "PR",
            "postal_code": "00949",
            "telephone_number": "787-261-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EMERGENCY ROOM PANA HOSPITAL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00910",
            "telephone_number": "787-727-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARIBEL",
        "middle_name": "NOBLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "14650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.