Individual provider Active NPI

Leychka Michelle Rodriguez, MD

  • General Practice Physician
  • Corozal, PR
National Provider Identifier
1669082640
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22616 Issued in PR
Practice address
Bo. Palmarejo KM 14.3 Carr 164
Corozal, PR 00783
Phone
(787) 725-7999
NPI assigned
Aug 5, 2020
Last updated
Feb 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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 22616 PR Primary

Addresses

Primary practice location

Bo. Palmarejo KM 14.3 Carr 164
Corozal, PR 00783

Mailing address

HC 1 Box 5060
Corozal, PR 00783-9369
Phone (787) 587-0515

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
I20250306003333 PR Practitioner - General Practice 7618498650 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22616PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Clinic of Caribbean, Inc General Practice CurrentSince Feb 1, 2025 Accepting new patients
Centro Imagenes Radiologia Toa Alta CurrentSince Feb 1, 2025 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": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1669082640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 5060",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "007839369",
            "telephone_number": "787-587-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO. PALMAREJO KM 14.3 CARR 164",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "00783",
            "telephone_number": "787-725-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LEYCHKA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2022-02-21",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corozal, PR

Sources for this page

Verify at the official NPI Registry.