Individual provider Active NPI

Juan Ramon Rodriguez

  • General Practice Physician
  • Lajas, PR
National Provider Identifier
1720727944
Registry record updated Jun 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22752 Issued in PR
Practice address
19 Erlich CT
Lajas, PR 00667-2624
Phone
(787) 317-6290
NPI assigned
Jun 4, 2022
Last updated
Jun 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 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 22752 PR Primary

Addresses

Primary practice location

19 Erlich CT
Lajas, PR 00667-2624

Mailing address

19 Erlich CT
Lajas, PR 00667-2624
Phone (787) 317-6290

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
I20220908000004 PR Practitioner - General Practice 6204210404 Reassigns benefits to 1 organization
Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Municipio de GuanicaGroup PAC ID 7214013812, 3 clinicians

Practice addresses (Care Compare)

Ramal 1116 KM
Suite 7
Guanica, PR 00663-0795
Phone (787) 821-0402

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22752PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Municipio de Guanica CurrentSince Jul 31, 2023 Accepting new patients
Municipio de Guanica General Practice CurrentSince Jul 31, 2023 Accepting new patients
Lab Santana LLC PastSince Mar 1, 2022 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, 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": "1654300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654300800000",
    "number": "1720727944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ERLICH CT",
            "city": "LAJAS",
            "state": "PR",
            "postal_code": "006672624",
            "telephone_number": "787-317-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 ERLICH CT",
            "city": "LAJAS",
            "state": "PR",
            "postal_code": "006672624",
            "telephone_number": "787-317-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JUAN",
        "middle_name": "RAMON",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-04",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lajas, PR

Sources for this page

Verify at the official NPI Registry.