Sergio Rafael Moure-Rodriguez, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

8128 Issued in PR

Practice address

Edif Instituto San Pablo
Suite 303
Bayamon, PR 00961-7041

Phone

(787) 787-7191

Fax

(787) 786-3667

NPI assigned

May 27, 2005

Last updated

Jan 13, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1508869165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3866",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009703866",
            "telephone_number": "787-787-7191",
            "fax_number": "787-786-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDIF INSTITUTO SAN PABLO",
            "address_2": "SUITE 303",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617041",
            "telephone_number": "787-787-7191",
            "fax_number": "787-786-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURE-RODRIGUEZ",
        "first_name": "SERGIO",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "8128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "29466",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST MEDICAL CARD SYSTEM",
            "identifier": "0116",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA CRUZ AZUL DE PR",
            "identifier": "066345",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UIA",
            "identifier": "33-08128",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH CARE",
            "identifier": "204040",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA HEALTH CARE",
            "identifier": "960010",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Specialist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.