Individual provider Active NPI

Nikitas Pablo Rodriguez, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • San Juan, PR
National Provider Identifier
1437730322
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
23421 Issued in PR
Practice address
Paseo Dr. Jose Celso Barbosa
San Juan, PR 00936
Phone
(787) 758-2525
NPI assigned
Apr 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 23421 PR Primary

Addresses

Primary practice location

Paseo Dr. Jose Celso Barbosa
San Juan, PR 00936

Mailing address

B Cond Jard de San Ignacio Apt 811B
San Juan, PR 00927-7017
Phone (787) 603-6712

Other practice location 1

Calle San Guillermo 1690
Coop. Jardines de San Ignacio apt. 811-B
San Juan, PR 00927
Phone (787) 603-6712

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
23421PRMDEmergency Medical Services (Emergency Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1437730322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "B COND JARD DE SAN IGNACIO APT 811B",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009277017",
            "telephone_number": "787-603-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PASEO DR. JOSE CELSO BARBOSA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00936",
            "telephone_number": "787-758-2525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Calle San Guillermo 1690",
            "address_2": "Coop. Jardines de San Ignacio apt. 811-B",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00927",
            "country_code": "US",
            "telephone_number": "787-603-6712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "NIKITAS",
        "middle_name": "PABLO",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2023-10-12",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "PR",
            "license": "23421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.