Individual provider Active NPI

Melisa Rodriguez, M.D

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1245327931
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15570 Issued in PR
Practice address
1866 Ave Ponce de Leon
San Juan, PR 00909-2010
Phone
(787) 346-0615
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 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 15570 PR Primary

Addresses

Primary practice location

1866 Ave Ponce de Leon
San Juan, PR 00909-2010

Mailing address

183 Chalets de la Playa
Vega Baja, PR 00693-9756
Phone (787) 268-4433

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
I20050803001050 PR Practitioner - General Practice 2668400227 Practice locations: Vega Alta, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15570PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1245327931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 CHALETS DE LA PLAYA",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006939756",
            "telephone_number": "787-268-4433",
            "fax_number": "787-268-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 AVE PONCE DE LEON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092010",
            "telephone_number": "787-346-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MELISA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.