Individual provider Active NPI

Jose Abimael Rosa Padilla, MD

  • Family Medicine Physician
  • Manati, PR
National Provider Identifier
1669148300
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22456 Issued in PR
Practice address
Calle Elliot Velez
Urb. Atenas J23
Manati, PR 00674
Phone
(787) 854-3851
NPI assigned
Aug 23, 2021
Last updated
Aug 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22456 PR Primary

Addresses

Primary practice location

Calle Elliot Velez
Urb. Atenas J23
Manati, PR 00674

Mailing address

PO Box 1096
Manati, PR 00674-1096
Phone (787) 854-3851

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL office Direct

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
I20220331000763 PR Practitioner - Family Practice 2466848403 Reassigns benefits to 2 organizations
Practice locations: Camuy, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22456PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Corporacion Servicios Medicos Primarios Y Prevencion de Hatillo Single Specialty CurrentSince Oct 2, 2023 Accepting new patients
Internal Medicine Integrated Services PSC Single Specialty CurrentSince Feb 19, 2025 Accepting new patients

Locations

121 Ave Dr Susoni
Hatillo, PR 00659
Phone (787) 314-5291

J23 Calle Elliot Velez
Manati, PR 00674
Phone (787) 854-0404

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": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1669148300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1096",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006741096",
            "telephone_number": "787-854-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE ELLIOT VELEZ",
            "address_2": "URB. ATENAS J23",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-854-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA PADILLA",
        "first_name": "JOSE",
        "middle_name": "ABIMAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "22456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "office",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Calle Elliot Velez",
            "address_2": "Urb. Atenas J23",
            "city": "Manati",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.