Individual provider Active NPI

Juan Manuel Rosa, MD

  • Occupational Medicine Physician
  • Aguadilla, PR
National Provider Identifier
1396948063
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
5190 Issued in PR
Practice address
Road 2 Km126.4
Caimital Bajo
Aguadilla, PR 00605
Phone
(787) 882-2700
Fax
(787) 882-4605
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 5190 PR Primary

Addresses

Primary practice location

Road 2 Km126.4
Caimital Bajo
Aguadilla, PR 00605

Mailing address

HC 6 Box 62992
Aguadilla, PR 00603-9829
Phone (787) 374-5711

Other identifiers 1

IdentifierTypeStateIssuer
5190OtherPRMEDICAL LIC.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5190PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
State Insurance Fund 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396948063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 6 BOX 62992",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006039829",
            "telephone_number": "787-374-5711",
            "fax_number": "787-882-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROAD 2 KM126.4",
            "address_2": "CAIMITAL BAJO",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00605",
            "telephone_number": "787-882-2700",
            "fax_number": "787-882-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA",
        "first_name": "JUAN",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "PR",
            "license": "5190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIC.",
            "identifier": "5190",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguadilla, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.