NPIMap

Individual provider Active NPI

Ivan Rafael Rodriguez Colon, M.D.

  • Family Medicine Physician
  • Juncos, PR
National Provider Identifier
1821085739
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15093 Issued in PR
Practice address
Street Number 31
Local D 2 Juncos Plaza
Juncos, PR 00777-1221
Phone
(787) 713-6505
Fax
(787) 713-6505
NPI assigned
Oct 5, 2005
Last updated
Jun 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15093 PR Primary
General Practice Physician 208D00000X 15093 PR

Addresses

Primary practice location

Street Number 31
Local D 2 Juncos Plaza
Juncos, PR 00777-1221

Mailing address

PO Box 1221
Juncos, PR 00777-1221
Phone (787) 713-6505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050706000936 PR Practitioner - General Practice 5092751586 Reassigns benefits to 4 organizations
Practice locations: Juncos, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Integral En la Montana IncGroup PAC ID 8527972827, shared by 11 NPIs, 64 clinicians

Practice addresses (Care Compare)

Carr 167 KM
8 Bo Pajaros Puertorriquenos
Bayamon, PR 00961
Phone (787) 780-3435

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15093PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc. Family Medicine CurrentSince Apr 20, 2021 Accepting new patients
Salud Integral En la Montana, Inc General Practice Current Accepting new patients
Salud Integral En la Montana, Inc Current Accepting new patients
Salud Integral En la Montana, Inc. General Practice Current Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Apr 20, 2021 Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Apr 21, 2021 Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 23, 2019 Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Mar 23, 2019 Accepting new patients
Occupational & Aesthetic Medicine Services, CSP Family Medicine Past Accepting new patients
Personal Home Physician Family Medicine Past Accepting new patients

Locations

156 Calle Barcelo
#53
Barranquitas, PR 00794
Phone (787) 857-2688

Organizations & group practices 10

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1821085739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1221",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007771221",
            "telephone_number": "787-713-6505",
            "fax_number": "787-713-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STREET NUMBER 31",
            "address_2": "LOCAL D 2 JUNCOS PLAZA",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007771221",
            "telephone_number": "787-713-6505",
            "fax_number": "787-713-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ COLON",
        "first_name": "IVAN",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "15093",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15093",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juncos, PR

Sources for this page

Verify at the official NPI Registry.