Ivan S Rodriguez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5659 Issued in PR

Practice address

40 Calle Mattei Lluberas
Yauco, PR 00698-3635

Phone

(787) 856-3380

Fax

(787) 856-3380

NPI assigned

Jun 23, 2006

Last updated

May 14, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1205862307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1418",
            "city": "LAJAS",
            "state": "PR",
            "postal_code": "006671418",
            "telephone_number": "787-808-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CALLE MATTEI LLUBERAS",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006983635",
            "telephone_number": "787-856-3380",
            "fax_number": "787-856-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "IVAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "5659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S INC",
            "identifier": "24682",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abner Rodriguez, MD
• Arnaldo Jose Rodriguez, LICENSED OPTICIAN
• Caroline Rodriguez, O.D
• Denisse J Rodriguez, R.PH
• Elliott Rodriguez, OD
• Jaime Rodriguez, O.D.
• Joan Manuel Rodriguez, M.D.
• Jorge Alejandro Rodriguez, M.D.
• Jorge L Rodriguez, D.M.D
• Junmayra Rodriguez

• Family Medicine Physician in Yauco, PR
• Providers in Yauco, PR by specialty
• Family Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.

Verify at the official NPI Registry.