Active NPI
Leticia Maria Fontanez Rodriguez
- General Practice Physician
- Rio Piedras, PR
National Provider Identifier
1538652938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 22525
- Practice address
- Centro Medico
Rio Piedras, PR 00924 - Phone
- (787) 763-4149
- NPI assigned
- Jun 11, 2018
- Last updated
- Sep 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 22525 | PR | Primary |
Addresses
Primary practice location
Centro Medico
Rio Piedras, PR 00924
Mailing address
PO Box 192566
San Juan, PR 00919-2566
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220204001847 | PR | Practitioner - General Practice | 6204229719 | Practice locations: Guaynabo, PR |
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Ave Las Cumbres
Professional Hospital
Guaynabo, PR 00969
Phone (787) 740-8787
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22525 | PR | MD | General Practice Physician |
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bayamon, PR
- NPI 1912992553
-
dba Hospital Metropolitano
- General Acute Care Hospital
- San Juan, PR
- NPI 1275580763
-
- General Acute Care Hospital
- Guaynabo, PR
- NPI 1922254952
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630627200000",
"number": "1538652938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 192566",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009192566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CENTRO MEDICO",
"city": "RIO PIEDRAS",
"state": "PR",
"postal_code": "00924",
"telephone_number": "787-763-4149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTANEZ RODRIGUEZ",
"first_name": "LETICIA",
"middle_name": "MARIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-11",
"last_updated": "2021-09-03",
"certification_date": "2021-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "22525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Piedras, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.