Individual provider Active NPI

Crystal Marie Monclova Rodriguez, LND, CMGI, CND

  • Nutritionist
  • San Juan, PR
National Provider Identifier
1447976683
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
2171 Issued in PR
Practice address
Ave Domenech 403 Local a
San Juan, PR 00918-0000
Phone
(787) 244-7952
NPI assigned
Oct 19, 2022
Last updated
Jan 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 2171 PR Primary
Registered Dietitian 133V00000X 2171 PR

Addresses

Primary practice location

Ave Domenech 403 Local a
San Juan, PR 00918-0000

Mailing address

Urb. Metropolis Street 46
2T21
Carolina, PR 00987
Phone (787) 449-8248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221216002417 PR Practitioner - Registered Dietitian Or Nutrition Professional 3274902028 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2171PRMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
HPM Foundation Inc Centro de Imagen CurrentSince Nov 1, 2022 Accepting new patients

Locations

2020 Ave Borinquen
Santurce, PR 00915

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": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1447976683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. METROPOLIS STREET 46",
            "address_2": "2T21",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "787-449-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE DOMENECH 403 LOCAL A",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009180000",
            "telephone_number": "787-244-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCLOVA RODRIGUEZ",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LND, CMGI, CND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PR",
            "license": "2171",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PR",
            "license": "2171",
            "primary": false
        }
    ],
    "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 Jan 28, 2026; 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.