Individual provider Active NPI

Sandra Raquel Rodriguez Rosario, M.D.

  • General Practice Physician
  • Canovanas, PR
National Provider Identifier
1720286313
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
11999 Issued in PR
Practice address
48 Calle Orquidea
Urb Loiza Valley
Canovanas, PR 00729-3596
Phone
(787) 256-0848
NPI assigned
Jul 5, 2007
Last updated
Feb 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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 11999 PR Primary

Addresses

Primary practice location

48 Calle Orquidea
Urb Loiza Valley
Canovanas, PR 00729-3596

Mailing address

235 Street Lluvia de Coral
Urb,Hacienda Real
Carolina, PR 00987
Phone (787) 473-5510

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
I20190220002309 PR Practitioner - General Practice 0840538682 Practice locations: Rio Grande, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Evaluacion Y Tratamiento Psicologico del Noreste CSP PastSince Oct 30, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1720286313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 STREET LLUVIA DE CORAL",
            "address_2": "URB,HACIENDA REAL",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "787-473-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 CALLE ORQUIDEA",
            "address_2": "URB LOIZA VALLEY",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007293596",
            "telephone_number": "787-256-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ ROSARIO",
        "first_name": "SANDRA",
        "middle_name": "RAQUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "11999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canovanas, PR

Sources for this page

Verify at the official NPI Registry.