Individual provider Active NPI

Virgen Milagros Rodriguez Perez, M.D.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1356342059
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q9015 Issued in TX
Practice address
25723 Old Fredericksburg Road
San Antonio, TX 78015
Phone
(210) 450-6800
Fax
(210) 450-6801
NPI assigned
Aug 3, 2005
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q9015 TX Primary
Family Medicine Physician 207Q00000X ME126089 FL
Family Medicine Physician 207Q00000X 8730 PR

Addresses

Primary practice location

25723 Old Fredericksburg Road
San Antonio, TX 78015

Mailing address

5788 Eckhert Rd
San Antonio, TX 78240-3900
Phone (210) 699-2100

Other practice location 1

Centro Medicina Familia, Road 172, Km 7.3,
Bo. Bayamon, Sector Certenejas
Cidra, PR 00739
Phone (787) 747-7839

Other identifiers 2

IdentifierTypeStateIssuer
362671502MedicaidTX
362671503OtherTXCSHCN

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
I20100712000233 PR Practitioner - Family Practice 3779615752 Practice locations: Cidra, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME126089FLMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1356342059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5788 ECKHERT RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403900",
            "telephone_number": "210-699-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25723 OLD FREDERICKSBURG ROAD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78015",
            "telephone_number": "210-450-6800",
            "fax_number": "210-450-6801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Centro Medicina Familia, Road 172, Km 7.3,",
            "address_2": "Bo. Bayamon, Sector Certenejas",
            "address_purpose": "LOCATION",
            "city": "Cidra",
            "state": "PR",
            "postal_code": "00739",
            "country_code": "US",
            "telephone_number": "787-747-7839",
            "fax_number": "787-961-0021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ PEREZ",
        "first_name": "VIRGEN",
        "middle_name": "MILAGROS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q9015",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME126089",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "8730",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362671502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "362671503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.