Individual provider Active NPI

Domingo Gilberto Rodriguez, MD

  • Internal Medicine Physician
  • Hato Rey, PR
National Provider Identifier
1376649749
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8692 Issued in PR
Practice address
Domenech 118
Hato Rey, PR 00918
Phone
(787) 765-1159
NPI assigned
Sep 15, 2006
Last updated
Feb 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8692 PR Primary

Addresses

Primary practice location

Domenech 118
Hato Rey, PR 00918

Mailing address

PO Box 1762
San Juan, PR 00919
Phone (787) 765-1159

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
I20110721000786 PR Practitioner - Internal Medicine 6204004005 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

118 Domenech St
Hato Rey
San Juan, PR 00918-3503
Phone (787) 765-1159

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8692PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caguas Optical Outlet, Inc Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1376649749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1762",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00919",
            "telephone_number": "787-765-1159",
            "fax_number": "787-282-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DOMENECH 118",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-765-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DOMINGO",
        "middle_name": "GILBERTO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "8692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hato Rey, PR

Sources for this page

Verify at the official NPI Registry.