Individual provider Active NPI

Jaime L. Rodriguez-Portela, PHYSICIAN

  • General Practice Physician
  • Vega Baja, PR
National Provider Identifier
1497746242
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14001 Issued in PR
Practice address
780 Calle Arrayadosandemtrio
Hospital Wilma N Vazquez Carr 2 KM 39.5
Vega Baja, PR 00693-3512
Phone
(787) 210-8127
NPI assigned
Nov 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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 14001 PR Primary

Addresses

Primary practice location

780 Calle Arrayadosandemtrio
Hospital Wilma N Vazquez Carr 2 KM 39.5
Vega Baja, PR 00693-3512

Mailing address

780 Calle Arrayado
San Demetrio
Vega Baja, PR 00693-3512
Phone (787) 210-8127

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
I20060301000162 PR Practitioner - General Practice 3476569492 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14001PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Instituto Medico del Norte Inc CurrentSince Jun 22, 2019 Accepting new patients
Instituto Medico del Norte Inc CurrentSince Jun 22, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1497746242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 CALLE ARRAYADO",
            "address_2": "SAN DEMETRIO",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006933512",
            "telephone_number": "787-210-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 CALLE ARRAYADOSANDEMTRIO",
            "address_2": "HOSPITAL WILMA N VAZQUEZ CARR 2 KM 39.5",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006933512",
            "telephone_number": "787-210-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-PORTELA",
        "first_name": "JAIME",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PHYSICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-01",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

Verify at the official NPI Registry.