Individual provider Active NPI

Luis E Rodriguez, M.D.

  • General Practice Physician
  • Dorado, PR
National Provider Identifier
1740305077
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
6190 Issued in PR
Practice address
503 Calle Ext S
Dorado, PR 00646-5016
Phone
(787) 796-3094
Fax
(787) 796-6709
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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 6190 PR Primary

Addresses

Primary practice location

503 Calle Ext S
Dorado, PR 00646-5016

Mailing address

PO Box 729
Dorado, PR 00646-0729
Phone (787) 796-3094

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
I20140402002078 PR Practitioner - General Practice 8123259272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

503 Calle Ext S
Dorado, PR 00646-5016
Phone (787) 306-6932

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6190PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Policlinica Dr Luis E. Rodriguez C.S.P. CurrentSince Dec 28, 2013 Accepting new patients

Locations

503 Calle Ext S
Dorado, PR 00646
Phone (787) 796-2900

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1740305077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006460729",
            "telephone_number": "787-796-3094",
            "fax_number": "787-796-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 CALLE EXT S",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006465016",
            "telephone_number": "787-796-3094",
            "fax_number": "787-796-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LUIS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "6190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

Verify at the official NPI Registry.