Individual provider Active NPI

Rafael Antonio Martinez, M.D.

  • Pediatrics Physician
  • San Juan, PR
National Provider Identifier
1891827127
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2354 Issued in PR
Practice address
121 Ave FD Roosevelt
Apt. 1404
San Juan, PR 00917-2725
Phone
(787) 763-1456
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2354 PR Primary

Addresses

Primary practice location

121 Ave FD Roosevelt
Apt. 1404
San Juan, PR 00917-2725

Mailing address

121 Ave Roosvelt
Apt. 1404
San Juan, PR 00917-2725
Phone (787) 763-1456

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
I20140606001366 PR Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0042434383

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2354PRMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891827127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 AVE ROOSVELT",
            "address_2": "APT. 1404",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009172725",
            "telephone_number": "787-763-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 AVE FD ROOSEVELT",
            "address_2": "APT. 1404",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009172725",
            "telephone_number": "787-763-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "RAFAEL",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "2354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.