Individual provider Active NPI

Olga D Rodriguez Rodriguez, M.D.

  • Pediatrics Physician
  • Ponce, PR
National Provider Identifier
1568517829
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
8327 Issued in PR
Practice address
388 Zona Ind Reparada 2
Ponce, PR 00716-2347
Phone
(787) 840-2575
Fax
(787) 840-9756
NPI assigned
Jan 24, 2007
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 8327 PR Primary

Addresses

Primary practice location

388 Zona Ind Reparada 2
Ponce, PR 00716-2347

Mailing address

304 Calle Sofia
Mansion Real
Coto Laurel, PR 00780-2630
Phone (787) 848-8816

Other identifiers 1

IdentifierTypeStateIssuer
8327OtherPRLICENSE

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
I20220103000694 PR Practitioner - Pediatric Medicine 0143475103 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tiber Health, Public Benefit Corporation CurrentSince Sep 8, 2021 Accepting new patients
Tiber Health, Public Benefit Corporation CurrentSince Sep 8, 2021 Accepting new patients
Tiber Health, Public Benefit Corporation PastSince Sep 29, 2024 Accepting new patients
Arist Medical Sciences University, Public Benefit Corporation Past Accepting new patients
Ponce Health Sciences University Past Accepting new patients

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1568517829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 CALLE SOFIA",
            "address_2": "MANSION REAL",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007802630",
            "telephone_number": "787-848-8816",
            "fax_number": "787-841-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 ZONA IND REPARADA 2",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162347",
            "telephone_number": "787-840-2575",
            "fax_number": "787-840-9756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ RODRIGUEZ",
        "first_name": "OLGA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "8327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "8327",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.