Individual provider Active NPI

Haydee Gely de la Rosa, M.D.

  • General Practice Physician
  • Juncos, PR
National Provider Identifier
1346232170
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14632 Issued in PR
Practice address
65 Calle Munoz Rivera
Juncos, PR 00777-3332
Phone
(787) 713-1500
Fax
(787) 687-2132
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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 14632 PR Primary

Addresses

Primary practice location

65 Calle Munoz Rivera
Juncos, PR 00777-3332

Mailing address

211 Calle Esparta
Urb Olympic Court
Las Piedras, PR 00771-9019
Phone (787) 713-1500

Other practice location 1

211 Calle Esparta
Urb Olympic Court
Las Piedras, PR 00771-9019
Phone (787) 713-1500

Other identifiers 1

IdentifierTypeStateIssuer
14632OtherPRSTATE MEDICAL LICENSE

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
I20040701001657 PR Practitioner - General Practice 0941287445 Reassigns benefits to 1 organization
Practice locations: Juncos, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14632PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HM Health Care LLC General Practice CurrentSince Jul 1, 2023 Accepting new patients

Locations

65 Calle Munoz Rivera
Juncos, PR 00777
Phone (787) 713-1500

115 Calle de Diego
San Lorenzo, PR 00754
Phone (787) 306-8519

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1346232170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 CALLE ESPARTA",
            "address_2": "URB OLYMPIC COURT",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007719019",
            "telephone_number": "787-713-1500",
            "fax_number": "787-713-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 CALLE MUNOZ RIVERA",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007773332",
            "telephone_number": "787-713-1500",
            "fax_number": "787-687-2132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 CALLE ESPARTA",
            "address_2": "URB OLYMPIC COURT",
            "address_purpose": "LOCATION",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007719019",
            "country_code": "US",
            "telephone_number": "787-713-1500",
            "fax_number": "787-713-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GELY DE LA ROSA",
        "first_name": "HAYDEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "14632",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Juncos, PR

Sources for this page

Verify at the official NPI Registry.