Individual provider Active NPI

Marielly Rodriguez, MSW

  • Clinical Social Worker
  • Aibonito, PR
National Provider Identifier
1487120259
Registry record updated May 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14558 Issued in PR
Practice address
Carretera 725 KM 3.3 Barrio Llanos Adentro
Aibonito, PR 00705
Phone
(787) 205-0473
NPI assigned
Oct 19, 2018
Last updated
May 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14558 PR Primary

Addresses

Primary practice location

Carretera 725 KM 3.3 Barrio Llanos Adentro
Aibonito, PR 00705

Mailing address

PO Box 9936
Aibonito, PR 00705

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190627003024 PR Practitioner - Clinical Social Worker 2163756958 Reassigns benefits to 2 organizations
Practice locations: Aibonito, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Centralis Med LLCGroup PAC ID 2860735289, 2 clinicians

Practice addresses (Care Compare)

Urb Condado Viejo
H17 Calle Jose Villares
Caguas, PR 00725-2463
Phone (787) 510-6187

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14558PRMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Behavioral Care Corp. Current Accepting new patients
Centralis Med LLC CurrentSince May 1, 2020 Accepting new patients
Centralis Med LLC. CurrentSince May 1, 2020 Accepting new patients
Inspira Behavioral Care Corp CurrentSince Feb 5, 2019 Accepting new patients
Inspira Behavioral Care Corp. CurrentSince Feb 5, 2019 Accepting new patients

Locations

55 Calle Comercio
Yauco, PR 00698
Phone (787) 267-1810

Organizations & group practices 5

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": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588982400000",
    "number": "1487120259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9936",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 725 KM 3.3 BARRIO LLANOS ADENTRO",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-205-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARIELLY",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2020-05-09",
        "certification_date": "2020-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "14558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aibonito, PR

Sources for this page

Verify at the official NPI Registry.