Edgardo Rodriguez Vallecillo, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

6941 Issued in PR

Practice address

29 Calle Washington
Suite 507
San Juan, PR 00907-1521

Phone

(787) 723-7230

Fax

(787) 723-2723

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

University of Puerto Rico School of Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425168000000",
    "number": "1235197765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 CALLE WASHINGTON",
            "address_2": "SUITE 507",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071521",
            "telephone_number": "787-723-7230",
            "fax_number": "787-723-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 CALLE WASHINGTON",
            "address_2": "SUITE 507",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071521",
            "telephone_number": "787-723-7230",
            "fax_number": "787-723-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ VALLECILLO",
        "first_name": "EDGARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2015-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PR",
            "license": "6941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nanichi Cristal Rodriguez Tardi
• Luis F Rodriguez Terry, M.D.
• Priscilla Maria Rodriguez Torres
• Yashira Marie Rodriguez Torres, MED , CPL
• Laura Paola Rodriguez Valedon, PSYD
• Dinamarca Rodriguez Vargas, MD
• Jose Juian Rodriguez Vazquez
• Natalia L Rodriguez Vazquez, MD
• Manuela Marie Rodriguez Vega, MSW
• Monica G. Rodriguez Velazquez, MD

• Dermatology Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Dermatology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.