Individual provider Active NPI

Walter Rosich, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1477630465
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5435 Issued in PR
Practice address
C8 S817
Villas de Parana
San Juan, PR 00926-6131
Phone
(787) 272-6612
Fax
(787) 272-6612
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

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
General Practice Physician 208D00000X 5435 PR Primary

Addresses

Primary practice location

C8 S817
Villas de Parana
San Juan, PR 00926-6131

Mailing address

PO Box 1570
Valle Arriba HTS Sta
Carolina, PR 00984-1570
Phone (787) 717-0099

Other identifiers 3

IdentifierTypeStateIssuer
3354OtherAM HEALTH CARE
065306OtherCRUZ AZUL
26373OtherTRIPLE S

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
I20080422000857 PR Practitioner - General Practice 5597843169 Practice locations: Carolina, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 TR Ave Sanchez Osorio
Villa Fontana
Carolina, PR 00983-3205

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5435PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477630465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1570",
            "address_2": "VALLE ARRIBA HTS STA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009841570",
            "telephone_number": "787-717-0099",
            "fax_number": "787-272-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C8 S817",
            "address_2": "VILLAS DE PARANA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266131",
            "telephone_number": "787-272-6612",
            "fax_number": "787-272-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSICH",
        "first_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "5435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AM HEALTH CARE",
            "identifier": "3354",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "065306",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "26373",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.