Individual provider Active NPI

Alexandra Estrada Rosa, RD

  • Registered Dietitian
  • San Juan, PR
National Provider Identifier
1336660281
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
001960 Issued in PR
Practice address
1492 Ave Ponce de Leon
Edif. Centro Europa 713
San Juan, PR 00907-4024
Phone
(787) 723-5017
Fax
(787) 723-5015
NPI assigned
Jun 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 001960 PR Primary

Addresses

Primary practice location

1492 Ave Ponce de Leon
Edif. Centro Europa 713
San Juan, PR 00907-4024

Mailing address

Urb Marina Bahia
MF-15, Plaza 32
Catano, PR 00962
Phone (787) 637-6627

Other identifiers 1

IdentifierTypeStateIssuer
1960OtherPRPR HEALTH DEPARTMENT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170927001604 PR Practitioner - Registered Dietitian Or Nutrition Professional 4789958976 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of Puerto Rico School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1492 Ave Ponce de Leon
Edif. Centro Europa 713
San Juan, PR 00907
Phone (787) 723-5017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1960PRMDCounseling Psychologist
001960PRMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Tu Nutricion Corporation Single Specialty PastSince Sep 24, 2016 Accepting new patients

Organizations & group practices 1

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": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1336660281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB MARINA BAHIA",
            "address_2": "MF-15, PLAZA 32",
            "city": "CATANO",
            "state": "PR",
            "postal_code": "00962",
            "telephone_number": "787-637-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 AVE PONCE DE LEON",
            "address_2": "EDIF. CENTRO EUROPA 713",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009074024",
            "telephone_number": "787-723-5017",
            "fax_number": "787-723-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA ROSA",
        "first_name": "ALEXANDRA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "PR",
            "license": "001960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PR HEALTH DEPARTMENT",
            "identifier": "1960",
            "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 Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.