Individual provider Active NPI

Edgar A Rodriguez Gonzalez, M.D

  • Pulmonary Disease Physician
  • San Juan, PR
National Provider Identifier
1639274814
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
9954 Issued in PR
Practice address
576 Calle Cesar Gonzalez
Suite 201
San Juan, PR 00918-3756
Phone
(787) 274-5405
Fax
(787) 274-5406
NPI assigned
Sep 13, 2006
Last updated
Jul 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 9954 PR Primary

Addresses

Primary practice location

576 Calle Cesar Gonzalez
Suite 201
San Juan, PR 00918-3756

Mailing address

576 Calle Cesar Gonzalez
Suite 201
San Juan, PR 00918-3756
Phone (787) 274-5405

Other names 1

  • Dr. Edgar A Rodriguez Gonzalez Former name

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
I20051219000180 PR Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 9133140197 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
University of Puerto Rico School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

576 Ave Cesar Gonzalez
Suite 201
San Juan, PR 00918

Adler Medical Plaza 576 Ave Cesar
Suite 201
San Juan, PR 00918

Adler Medical Plaza 576 Cesar Gonzale
Suite 201
San Juan, PR 00918
Phone (782) 274-5405

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9954PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Instituto Neumologico de Puerto Rico Past Accepting new patients

Organizations & group practices 1

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.

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1639274814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 CALLE CESAR GONZALEZ",
            "address_2": "SUITE 201",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183756",
            "telephone_number": "787-274-5405",
            "fax_number": "787-274-5406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 CALLE CESAR GONZALEZ",
            "address_2": "SUITE 201",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183756",
            "telephone_number": "787-274-5405",
            "fax_number": "787-274-5406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ GONZALEZ",
        "first_name": "EDGAR",
        "middle_name": "A",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PR",
            "license": "9954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDGAR",
            "last_name": "RODRIGUEZ GONZALEZ",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.