Individual provider Active NPI

Kathia Sheilee Baucage Rodriguez, MD

  • Physical Medicine & Rehabilitation Physician
  • Moca, PR
National Provider Identifier
1568566271
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
16308 Issued in PR
Practice address
550 Calle Concepcion Vera
Moca, PR 00676-5005
Phone
(787) 877-3466
Fax
(787) 882-5405
NPI assigned
Sep 12, 2006
Last updated
Feb 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 16308 PR Primary

Addresses

Primary practice location

550 Calle Concepcion Vera
Moca, PR 00676-5005

Mailing address

PO Box 855
Moca, PR 00676-0855
Phone (787) 877-3466

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
I20070123000013 PR Practitioner - Physical Medicine and Rehabilitation 4880695600 Reassigns benefits to 1 organization
Practice locations: Aguadilla, PR

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Ponce School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

550 Calle Concepcion Vera
Moca, PR 00676-5005
Phone (407) 989-5845

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16308PRMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kbaucage Fisiatra Past 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, 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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1568566271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 855",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006760855",
            "telephone_number": "787-877-3466",
            "fax_number": "787-877-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CALLE CONCEPCION VERA",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006765005",
            "telephone_number": "787-877-3466",
            "fax_number": "787-882-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUCAGE RODRIGUEZ",
        "first_name": "KATHIA",
        "middle_name": "SHEILEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PR",
            "license": "16308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moca, PR

Sources for this page

Verify at the official NPI Registry.