Individual provider Active NPI

Victor Manuel Rodriguez Perez, MD

  • General Practice Physician
  • Sabana Grande, PR
National Provider Identifier
1255433629
Registry record updated Apr 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14412 Issued in PR
Practice address
Calle Angel M Quinones
Policlinica Dr Marin
Sabana Grande, PR 00698
Phone
(787) 804-0115
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2014

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 14412 PR Primary

Addresses

Primary practice location

Calle Angel M Quinones
Policlinica Dr Marin
Sabana Grande, PR 00698

Mailing address

Flamboyan S C 12 Urb Valle Hermoso
Hormigueros, PR 00660
Phone (787) 384-2752

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
I20061121000006 PR Practitioner - General Practice 9931107299 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Anesthesia Associates LLC Current Accepting new patients
Hospital Damas Inc CurrentSince Oct 17, 2018 Accepting new patients
Centro de Diagnostico Y Tratamiento de San Sebastian Inc Past Accepting new patients

Locations

2213 Ponce Byp
Ponce, PR 00717
Phone (787) 368-7802

Organizations & group practices 3

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396569600000",
    "number": "1255433629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FLAMBOYAN S C 12 URB VALLE HERMOSO",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "00660",
            "telephone_number": "787-384-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE ANGEL M QUINONES",
            "address_2": "POLICLINICA DR MARIN",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "00698",
            "telephone_number": "787-804-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ PEREZ",
        "first_name": "VICTOR",
        "middle_name": "MANUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2014-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sabana Grande, PR

Sources for this page

Verify at the official NPI Registry.