Individual provider Active NPI

Gladynette Rosario, M.D.

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1205822731
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16005 Issued in PR
Practice address
Galerias de Escorial Shopp. Center
5725 Blvd. Media Luna Suite 5
Carolina, PR 00987-3515
Phone
(787) 579-6490
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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 16005 PR Primary

Addresses

Primary practice location

Galerias de Escorial Shopp. Center
5725 Blvd. Media Luna Suite 5
Carolina, PR 00987-3515

Mailing address

PO Box 1893
Carolina, PR 00984-1893
Phone (787) 769-6684

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
I20051013000319 PR Practitioner - General Practice 4385669837 Practice locations: Carolina, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4002 Ave Sur Apto
1402 Cond Torres de Escorial
Carolina, PR 00987

5725 Blvd Media Luna
Carolina, PR 00987-5198
Phone (787) 769-6684

PO Box
Suite 1893
Carolina, PR 00984-1893

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1205822731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1893",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009841893",
            "telephone_number": "787-769-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GALERIAS DE ESCORIAL SHOPP. CENTER",
            "address_2": "5725 BLVD. MEDIA LUNA SUITE 5",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009873515",
            "telephone_number": "787-579-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "GLADYNETTE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.