Individual provider Active NPI

Alexis Otero Rosado, MD

  • Family Medicine Physician
  • Manati, PR
National Provider Identifier
1376912444
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19182 Issued in PR
Practice address
MMC Professional Plaza
Ste 309
Manati, PR 00674
Phone
(787) 404-3173
NPI assigned
Sep 18, 2015
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 19182 PR Primary

Addresses

Primary practice location

MMC Professional Plaza
Ste 309
Manati, PR 00674

Mailing address

PO Box 127
Manati, PR 00674-0127
Phone (787) 404-3173

Other practice location 1

A1 Calle Isabel
Mansiones Reales
San German, PR 00683-9810
Phone (787) 404-3173

Other identifiers 1

IdentifierTypeStateIssuer
037828801MedicaidPR

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
I20200807002001 PR Practitioner - Family Practice 7810312808 Reassigns benefits to 1 organization
Practice locations: Arecibo, PR

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Ave San Luis Carr 129 KM
Suite 0
Arecibo, PR 00612
Phone (787) 404-3173

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Luis R Rosa Toledo Medicina de Familia CP Single Specialty CurrentSince Jul 1, 2020 Accepting new patients
Metrohealth, Inc. Single Specialty Past Accepting new patients
Anesthesia 2010, CSP Single Specialty PastSince Sep 25, 2014 Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1376912444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740127",
            "telephone_number": "787-404-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC PROFESSIONAL PLAZA",
            "address_2": "STE 309",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-404-3173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "A1 Calle Isabel",
            "address_2": "Mansiones Reales",
            "address_purpose": "LOCATION",
            "city": "San German",
            "state": "PR",
            "postal_code": "006839810",
            "country_code": "US",
            "telephone_number": "787-404-3173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTERO ROSADO",
        "first_name": "ALEXIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "19182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037828801",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.