Organization Active NPI

Dr Angel Rodriguez Quinones PSC

  • Primary Care Clinic/Center
  • San Juan, PR
National Provider Identifier
1285914382
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
6853 Issued in PR
Legal business name
DR ANGEL RODRIGUEZ QUINONES PSC
Practice address
Urb. Perez Morris
Mayaguez 33
San Juan, PR 00917-4917
Phone
(787) 764-6077
NPI assigned
Aug 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Authorized official

Name
Dr. Angel Luis Rodriguez, M.D.
Title
President
Phone
(787) 764-6077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 6853 PR Primary

Addresses

Primary practice location

Urb. Perez Morris
Mayaguez 33
San Juan, PR 00917-4917

Mailing address

PO Box 192102
San Juan, PR 00919-2102
Phone (787) 764-6077

Other identifiers 1

IdentifierTypeStateIssuer
FV704AOtherPRPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120313000240 PR Part B Supplier - Clinic/Group Practice 7214196187 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

33 Calle Mayaguez
San Juan, PR 00917
Phone (757) 764-6077

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1285914382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192102",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009192102",
            "telephone_number": "787-764-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. PEREZ MORRIS",
            "address_2": "MAYAGUEZ 33",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009174917",
            "telephone_number": "787-764-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ANGEL RODRIGUEZ QUINONES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-764-6077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PR",
            "license": "6853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "FV704A",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.