Individual provider Active NPI

Jose Ramon Fuentes Rodriguez, M.D.

  • Anesthesiology Physician
  • San German, PR
National Provider Identifier
1619962446
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
6899 Issued in PR
Practice address
#8 C. Luz Celenia Tirado
San German, PR 00683
Phone
(787) 529-5545
NPI assigned
Sep 19, 2005
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 6899 PR Primary

Addresses

Primary practice location

#8 C. Luz Celenia Tirado
San German, PR 00683

Mailing address

Box 216
Sector Espinoza
Bayamon, PR 00960
Phone (787) 529-5545

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
I20070831000120 PR Practitioner - Anesthesiology 2365535739 Practice locations: San German, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6899PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric J Sambolin Morales LLC CurrentSince Aug 4, 2024 Accepting new patients
Dba Humacao Anesthesia Service Anesthesiology Past Accepting new patients

Locations

8 Calle Javilla
San German, PR 00683
Phone (787) 892-2880

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1619962446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 216",
            "address_2": "SECTOR ESPINOZA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00960",
            "telephone_number": "787-529-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#8 C. LUZ CELENIA TIRADO",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-529-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "RAMON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PR",
            "license": "6899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

Verify at the official NPI Registry.