Individual provider Active NPI

Griselle Pastrana Rodriguez, MD

  • Family Medicine Physician
  • Humacao, PR
National Provider Identifier
1710010830
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12761 Issued in PR
Practice address
355 Font Martelo
Humacao, PR 00792-0076
Phone
(787) 646-8768
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 12761 PR Primary

Addresses

Primary practice location

355 Font Martelo
Humacao, PR 00792-0076

Mailing address

PO Box 76
Humacao, PR 00792-0076
Phone (787) 646-8768

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
I20080401000763 PR Practitioner - Family PracticePractitioner - Geriatric Medicine 6709963739 Reassigns benefits to 1 organization
Practice locations: Humacao, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12761PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cossma, Inc. CurrentSince Mar 20, 2013 Accepting new patients
Cossma Inc CurrentSince Mar 20, 2013 Accepting new patients
Ryder Memorial Hospital Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710010830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 76",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007920076",
            "telephone_number": "787-646-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 FONT MARTELO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007920076",
            "telephone_number": "787-646-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTRANA RODRIGUEZ",
        "first_name": "GRISELLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "12761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.