Individual provider Active NPI

Jaminette Rodriguez, MD

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1861912099
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19682 Issued in PR
Practice address
Carr 829 KM 1.1
Bo Buena Vista
Bayamon, PR 00956-9403
Phone
(787) 422-2535
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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 19682 PR Primary

Addresses

Primary practice location

Carr 829 KM 1.1
Bo Buena Vista
Bayamon, PR 00956-9403

Mailing address

RR 4 Box 2784
Bayamon, PR 00956-9403
Phone (787) 422-2535

Other identifiers 2

IdentifierTypeStateIssuer
000000000OtherPRNONE
00000000000OOtherNONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19682PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1861912099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 4 BOX 2784",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009569403",
            "telephone_number": "787-422-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 829 KM 1.1",
            "address_2": "BO BUENA VISTA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009569403",
            "telephone_number": "787-422-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JAMINETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "000000000",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "00000000000O",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.