Individual provider Active NPI

Karla Marie Rodriguez Tirado, MD

  • Family Medicine Physician
  • Aibonito, PR
National Provider Identifier
1467907352
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21712 Issued in PR
Practice address
165 Calle Baldorioty N
Aibonito, PR 00705-3234
Phone
(787) 694-3202
NPI assigned
Aug 20, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centro Servicios Primarios de Salud de Patillas Inc. 20 clinicians

Practice addresses (Care Compare)

99 Calle Guillermo Riefkhol
Patillas, PR 00723-2838

99 Calle Riefkohl
Patillas, PR 00723-2838
Phone (787) 839-4320

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
I20210422001912 PR Practitioner - Family Practice 8921416447 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21712PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Servicios Primarios de Salud de Patillas Inc. CurrentSince Aug 12, 2024 Accepting new patients
Centro Servicios Primarios de Salud de Patillas Inc. CurrentSince Aug 12, 2024 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21712 PR Primary

Addresses

NPPES NPI Registry

Primary practice location

165 Calle Baldorioty N
Aibonito, PR 00705-3234

Mailing address

PO Box 521
Patillas, PR 00723-0521
Phone (787) 929-1505

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 21, 2023.

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1467907352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 521",
            "city": "PATILLAS",
            "state": "PR",
            "postal_code": "007230521",
            "telephone_number": "787-929-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 CALLE BALDORIOTY N",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "007053234",
            "telephone_number": "787-694-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ TIRADO",
        "first_name": "KARLA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-20",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "21712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aibonito, PR

Sources for this page

Verify at the official NPI Registry.