Individual provider Active NPI

Ismael Rosado Lopez, MD

  • Internal Medicine Physician
  • Ponce, PR
National Provider Identifier
1558857219
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22191 Issued in PR
Practice address
917 Ave Tito Castro
Ponce, PR 00716-4717
Phone
(787) 844-2080
NPI assigned
Jul 6, 2018
Last updated
Feb 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22191 PR Primary

Addresses

Primary practice location

917 Ave Tito Castro
Ponce, PR 00716-4717

Mailing address

917 Ave Tito Castro
Ponce, PR 00716-4717
Phone (787) 844-2080

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
I20210914001277 PR Practitioner - Internal Medicine 0244636413 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Urb Rio Canas
1607 Calle Guadiana
Ponce, PR 00728-0200
Phone (787) 813-2222

Urb Rio Canas 1607 Calle
Guadiana
Ponce, PR 00728-0200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mennonite General Hospital Inc CurrentSince Aug 1, 2021 Accepting new patients
Mennonite General Hospital Inc. CurrentSince Aug 1, 2021 Accepting new patients
Irl Internal Medicine LLC Internal Medicine CurrentSince Jun 3, 2022 Accepting new patients
Mennonite General Hospital Inc Current Accepting new patients
Hospital Damas Inc Past Accepting new patients

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1558857219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 AVE TITO CASTRO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164717",
            "telephone_number": "787-844-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 AVE TITO CASTRO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164717",
            "telephone_number": "787-844-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO LOPEZ",
        "first_name": "ISMAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-06",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "22191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.