Individual provider Active NPI

Nitzalise Esther Carrasquillo Rodriguez, MD

  • General Practice Physician
  • Rio Grande, PR
National Provider Identifier
1609396373
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19684 Issued in PR
Practice address
Calle 17 R-921
Alturas de Rio Grande
Rio Grande, PR 00745
Phone
(787) 909-4302
NPI assigned
Jun 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 19684 PR Primary

Addresses

Primary practice location

Calle 17 R-921
Alturas de Rio Grande
Rio Grande, PR 00745

Mailing address

Calle 17 R-921
Alturas de Rio Grande
Rio Grande, PR 00745
Phone (787) 909-4302

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
I20171113002973 PR Practitioner - General Practice 1153687827 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ER Specialized Care LLCGroup PAC ID 6507122967, 19 clinicians

Practice addresses (Care Compare)

Avenida Juan Ponce de Leon Parada
37 Hospital Auxilio Mutuo
Hato Rey, PR 00919
Phone (787) 758-2000

Hospital & facility affiliations

  • Auxilio Mutuo Hospital Hospital, San Juan, PR, CCN 400016

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc General Practice CurrentSince Sep 23, 2017 Accepting new patients
ER Specialized Care LLC CurrentSince Jan 8, 2024 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Sep 23, 2017 Accepting new patients

Locations

70 Calle Santa Cruz
Bayamon, PR 00961
Phone (787) 620-1639

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1609396373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE 17 R-921",
            "address_2": "ALTURAS DE RIO GRANDE",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "00745",
            "telephone_number": "787-909-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 17 R-921",
            "address_2": "ALTURAS DE RIO GRANDE",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "00745",
            "telephone_number": "787-909-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASQUILLO RODRIGUEZ",
        "first_name": "NITZALISE",
        "middle_name": "ESTHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, PR

Sources for this page

Verify at the official NPI Registry.