Tanama Healthcare LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

TANAMA HEALTHCARE LLC

Practice address

102 Calle Francisco Jaurregui
Arecibo, PR 00612-4572

Phone

(787) 816-5041

Fax

(787) 881-5742

NPI assigned

Aug 18, 2022

Last updated

Aug 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dante Isaac Rodriguez Gonzalez, MD, MHSANPI 1194245365

Title

Ceo & Owner

Phone

(787) 816-5041

Specialties & licenses 5

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dante Isaac Rodriguez Gonzalez, MD

  • General Practice Physician
  • Arecibo, PR
  • NPI 1194245365
  Medicare reassignment NPD Authorized official
• Andrea Fuster, DC

  • Chiropractor
  • San Juan, PR
  • NPI 1194221549
  NPD
• David Hernandez Rivera, MD

  • Family Medicine Physician
  • San Juan, PR
  • NPI 1629592936
  NPD
• Xavier Elias Jimenez, PA

  • Medical Physician Assistant
  • Arecibo, PR
  • NPI 1285456038
  NPD
• Carolina Mercedes Rios, PSYD

  • Clinical Psychologist
  • Arecibo, PR
  • NPI 1487461455
  NPD
• Dante Amadis Rodriguez

  • Internal Medicine Physician
  • Arecibo, PR
  • NPI 1467465567
  NPD (past)
• Maria Isabel Rodriguez, RD

  • Registered Dietitian
  • San Juan, PR
  • NPI 1861223406
  NPD (past)

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691798400000",
    "number": "1427776186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 CALLE UN APT G1",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009074202",
            "telephone_number": "787-506-0723",
            "fax_number": "787-881-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CALLE FRANCISCO JAURREGUI",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006124572",
            "telephone_number": "787-816-5041",
            "fax_number": "787-881-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANAMA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2023-08-12",
        "certification_date": "2023-08-12",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ GONZALEZ",
        "authorized_official_first_name": "DANTE",
        "authorized_official_middle_name": "ISAAC",
        "authorized_official_title_or_position": "CEO & OWNER",
        "authorized_official_telephone_number": "787-816-5041",
        "authorized_official_credential": "MD, MHSA"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1194221549",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1194245365",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PRACTIFUSION",
            "affiliation": "N",
            "endpointDescription": "RECORD ELECTRONIC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "102 Calle Francisco Jaurregui",
            "city": "Arecibo",
            "state": "PR",
            "country_code": "US",
            "postal_code": "006124572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Arecibo, PR
• Providers in Arecibo, PR by specialty
• Multi-Specialty Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.