Antonio Juan Rodriguez Mimoso, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

12583 Issued in PR

Practice address

Ave FD Roosevelt #400
Suite304
Hato Rey, PR 00918

Phone

(787) 763-6065

Fax

(787) 753-0054

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Obstetrics/Gynecology

Education

Virginia Commonwealth University, School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinica Las Americas Guaynabo, IncGroup PAC ID 3476504077, 49 clinicians

The OB/GYN Professionals Group PSCGroup PAC ID 3779647094, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: antonio.rodriguezmimoso@4048.securemail.prognocis.com

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.

• Clinica Las Americas Guaynabo, Inc

  • Multi-Specialty Clinic/Center
  • Bayamon, PR
  • NPI 1326096058

  Obstetrics & Gynecology, PR

  Medicare reassignment Care Compare group NPD
• The OB-GYN Professionals Group PSC

  • Specialist
  • San Juan, PR
  • NPI 1477513521

  PR

  Medicare reassignment Care Compare group NPD
• Clinica Las Americas Guaynabo, Inc

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • San Juan, PR
  • NPI 1366053845
  NPD

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1912967993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVE FD ROOSEVELT #400",
            "address_2": "SUITE304",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-763-6065",
            "fax_number": "787-753-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE FD ROOSEVELT #400",
            "address_2": "SUITE304",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-763-6065",
            "fax_number": "787-753-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ MIMOSO",
        "first_name": "ANTONIO",
        "middle_name": "JUAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PR",
            "license": "12583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wanda Yadira Rivera, DRA
• Yilda M Rivera, DDS
• Liliana Rodriguez Diaz
• Elaisa Rodriguez Gutierrez, MSW
• Nancy Rodriguez Marrero, PT
• Patricia Anne Rodriguez Reyes, MD
• Brenda Rodriguez Velez, PT
• Domingo Gilberto Rodriguez, MD
• Jorge Efrain Rodriguez, M.D.
• Loreni Rodriguez

• Obstetrics & Gynecology Physician in Hato Rey, PR
• Providers in Hato Rey, PR by specialty
• Obstetrics & Gynecology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.