Individual provider Active NPI

Maribel Rodriguez-Martinez, M.D.

  • Emergency Medicine Physician
  • San Juan, PR
National Provider Identifier
1730125410
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13316 Issued in PR
Practice address
715 Ave Ponce de Leon
San Juan, PR 00918-1607
Phone
(787) 758-2000
Fax
(787) 771-7869
NPI assigned
Jun 21, 2006
Last updated
Dec 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 13316 PR
Specialist 174400000X 0101-049298 VA
Emergency Medicine Physician 207P00000X 13316 PR Primary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 13316 PR
Hospitalist Physician 208M00000X 13316 PR

Addresses

Primary practice location

715 Ave Ponce de Leon
San Juan, PR 00918-1607

Mailing address

PO Box 366210
San Juan, PR 00936-6210
Phone (787) 758-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20160113002333 VA Practitioner - Emergency Medicine 9234382532 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101-049298VAMDSpecialist
13316PRMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ingleside Emergency Group, LLC Emergency Medicine CurrentSince Jun 23, 2018 Accepting new patients
Kingsford Emergency Group, LLC Emergency Medicine CurrentSince Jun 26, 2018 Accepting new patients
Emergency Physicians of Southern Virginia LLP Emergency Medicine CurrentSince Jan 15, 2018 Accepting new patients
Kingsford Physician Services, LLC Hospitalist CurrentSince Jul 1, 2018 Accepting new patients
Valley Presbyterian Emergency Medical Associates Emergency Medicine PastSince Aug 7, 2022 Accepting new patients
Emergenciologos Para Puerto Rico,CSP Pediatric Emergency Medicine Past Accepting new patients
Valley Emergency Medical Associates, Inc. Emergency Medicine Past Accepting new patients
Valley Emergency Medical Associates Emergency Medicine Past Accepting new patients

Locations

200 Hospital Dr
Galax, VA 24333
Phone (276) 236-6011

1 Arh Ln
Low Moor, VA 24457
Phone (540) 345-2593

2400 Lee Hwy N
Pulaski, VA 24301
Phone (540) 994-8100

Organizations & group practices 9

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1730125410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366210",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009366210",
            "telephone_number": "787-758-2000",
            "fax_number": "787-771-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 AVE PONCE DE LEON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009181607",
            "telephone_number": "787-758-2000",
            "fax_number": "787-771-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-MARTINEZ",
        "first_name": "MARIBEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "13316",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101-049298",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "13316",
            "primary": true
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "PR",
            "license": "13316",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PR",
            "license": "13316",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.