Individual provider Active NPI

Jose A Rosario Rodriguez, MD

  • General Practice Physician
  • Humacao, PR
National Provider Identifier
1295964831
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17633 Issued in PR
Practice address
A6 Calle 14
Urb Villa Humacao
Humacao, PR 00791-4627
Phone
(787) 372-0456
NPI assigned
Jul 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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 17633 PR Primary

Addresses

Primary practice location

A6 Calle 14
Urb Villa Humacao
Humacao, PR 00791-4627

Mailing address

A6 Calle 14
Urb Villa Humacao
Humacao, PR 00791-4627
Phone (787) 372-0456

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
I20091210000082 PR Practitioner - General PracticePractitioner - Emergency Medicine 3375682065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Rehabilitation Services IncGroup PAC ID 0345406187, shared by 2 NPIs, 51 clinicians

Practice addresses (Care Compare)

Ave General Valero
410 Suite 307
Fajardo, PR 00738-3982
Phone (787) 863-4058

Uu43 Calle
Suite 30
Bayamon, PR 00956-4701
Phone (787) 787-8669

Hospital & facility affiliations

  • Caribbean Medical Center Hospital, Fajardo, PR, CCN 400131

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mi Medico Primario, LLC CurrentSince Jan 26, 2020 Accepting new patients
Multi Business Solutions General Practice CurrentSince May 1, 2023 Accepting new patients
East Coast Medical Group Inc Past Accepting new patients

Locations

410 Ave General Valero
Ste 307
Fajardo, PR 00738
Phone (787) 863-4058

1607 Ave Ponce de Leon
Ste GM6
San Juan, PR 00909
Phone (787) 400-5671

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1295964831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "A6 CALLE 14",
            "address_2": "URB VILLA HUMACAO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914627",
            "telephone_number": "787-372-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A6 CALLE 14",
            "address_2": "URB VILLA HUMACAO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914627",
            "telephone_number": "787-372-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.