Individual provider Active NPI

Manuel Junior Rodriguez Sr.

  • Clinical Social Worker
  • Cayey, PR
National Provider Identifier
1891495040
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12957 Issued in PR
Practice address
Paseos Dorados #66 Cayey P.R 0
Cayey, PR 00736
Phone
(787) 664-1501
NPI assigned
Mar 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12957 PR Primary

Addresses

Primary practice location

Paseos Dorados #66 Cayey P.R 0
Cayey, PR 00736

Mailing address

PO Box 153
La Plata, PR 00786-0153

Other identifiers 1

IdentifierTypeStateIssuer
1008070621OtherPRPRACTICE PRIVATE

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

State licenses

LicenseStateTypeSpecialty
12957PRMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1891495040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 153",
            "city": "LA PLATA",
            "state": "PR",
            "postal_code": "007860153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PASEOS DORADOS #66 CAYEY P.R 0",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "00736",
            "telephone_number": "787-664-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MANUEL",
        "middle_name": "JUNIOR",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "12957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE PRIVATE",
            "identifier": "1008070621",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayey, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.