Individual provider Active NPI

Jesus Rodriguez, M.D.,F.A.C.O.G,F.A.C

  • Specialist
  • San Juan, PR
National Provider Identifier
1619910122
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4291 Issued in PR
Practice address
158 Calle Los Mirtos
Hyde Park
San Juan, PR 00927-4236
Phone
(787) 250-0276
Fax
(787) 756-5618
NPI assigned
Jun 13, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4291 PR Primary

Addresses

Primary practice location

158 Calle Los Mirtos
Hyde Park
San Juan, PR 00927-4236

Mailing address

PO Box 194557
San Juan, PR 00919-4557
Phone (787) 250-0276

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
I20120709000337 PR Practitioner - Obstetrics/GynecologyPractitioner - Gynecological Oncology 0244495745 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Gynecological Oncology
Education
University of Puerto Rico School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Los Mirtos
158 Urb Hyde Park
San Juan, PR 00926
Phone (787) 250-0276

Hospital & facility affiliations

National Provider Directory

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

Hospital & facility affiliations 2

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619910122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 194557",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009194557",
            "telephone_number": "787-250-0276",
            "fax_number": "787-756-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 CALLE LOS MIRTOS",
            "address_2": "HYDE PARK",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009274236",
            "telephone_number": "787-250-0276",
            "fax_number": "787-756-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JESUS",
        "name_prefix": "Dr.",
        "credential": "M.D.,F.A.C.O.G,F.A.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "4291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.