Individual provider Active NPI

Alexandra G Perez Rodriguez, MHSN, LND

  • Nutritionist
  • Yauco, PR
National Provider Identifier
1891458097
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
2035 Issued in PR
Practice address
13B Calle Baldorioty
Yauco, PR 00698-3654
Phone
(787) 235-7013
NPI assigned
Oct 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X 2035 PR
Registered Dietitian 133V00000X 2035 PR
NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133N00000X 2035 PR Primary

Addresses

Primary practice location

13B Calle Baldorioty
Yauco, PR 00698-3654

Mailing address

Urb Veredas de Yauco
Calle Ramal 307
Yauco, PR 00698
Phone (939) 335-1216

Other practice location 1

Millenium Tower
Suite 101 880 Ave Tito Castro
Ponce, PR 00716
Phone (787) 235-7013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220509000075 PR Practitioner - Registered Dietitian Or Nutrition Professional 7416334784 Reassigns benefits to 1 organization
Practice locations: Yauco, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2035PRMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Esperanza MD LLC Single Specialty CurrentSince Nov 5, 2023 Accepting new patients
Longevity Nutrition Services, LLC Nutritionist CurrentSince Jul 1, 2024 Accepting new patients

Locations

880 Ave Tito Castro
Ste 101
Ponce, PR 00716
Phone (787) 235-7013

13B Calle Baldorioty
Yauco, PR 00698
Phone (787) 235-7013

Organizations & group practices 2

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": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1891458097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB VEREDAS DE YAUCO",
            "address_2": "CALLE RAMAL 307",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "00698",
            "telephone_number": "939-335-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13B CALLE BALDORIOTY",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006983654",
            "telephone_number": "787-235-7013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "MILLENIUM TOWER",
            "address_2": "SUITE 101 880 AVE TITO CASTRO",
            "address_purpose": "LOCATION",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00716",
            "country_code": "US",
            "telephone_number": "787-235-7013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ RODRIGUEZ",
        "first_name": "ALEXANDRA",
        "middle_name": "G",
        "credential": "MHSN, LND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "PR",
            "license": "2035",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PR",
            "license": "2035",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": "PR",
            "license": "2035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yauco, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.