Individual provider Active NPI

Carla Michelle Rosario, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1336195205
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15569 Issued in PR
Practice address
Sergio Cuevas Bustamante St
# 523 Urb. Parque Central
San Juan, PR 00918
Phone
(787) 294-9399
Fax
(787) 294-9978
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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 15569 PR Primary

Addresses

Primary practice location

Sergio Cuevas Bustamante St
# 523 Urb. Parque Central
San Juan, PR 00918

Mailing address

D Street H5
Urb Torremolinos Este
Guaynabo, PR 00969
Phone (787) 237-5405

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
I20060823000229 PR Practitioner - General Practice 6406859974 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

523 Sergio Cuevas Bustamante
Parque Central
San Juan, PR 00918-3741
Phone (787) 294-9399

550 Sergio Cuevas Bustamante
Hospital El Maestro
San Juan, PR 00918-3741
Phone (787) 753-7123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15569PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1336195205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "D STREET H5",
            "address_2": "URB TORREMOLINOS ESTE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-237-5405",
            "fax_number": "787-790-8872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SERGIO CUEVAS BUSTAMANTE ST",
            "address_2": "# 523 URB. PARQUE CENTRAL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-294-9399",
            "fax_number": "787-294-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "CARLA",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.