Individual provider Active NPI

Mariana Isabel Rodriguez

  • Emergency Medicine Physician
  • Ponce, PR
National Provider Identifier
1922395250
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
18611 Issued in PR
Practice address
917 Tito Castro Ave
Ponce, PR 00716
Phone
(787) 844-2080
NPI assigned
Jul 7, 2011
Last updated
Jan 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 18611 PR Primary

Addresses

Primary practice location

917 Tito Castro Ave
Ponce, PR 00716

Mailing address

PO Box 336810
Ponce, PR 00733-6810
Phone (787) 844-2080

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
I20160323001413 PR Practitioner - Emergency Medicine 6901103688 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18611PRMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Damas Inc CurrentSince Jan 20, 2019 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Jan 26, 2016 Accepting new patients
Southern Anesthesia Associates LLC Current Accepting new patients
Centro Medico del Turabo Inc CurrentSince Jan 26, 2016 Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

2213 Ponce Byp
Ponce, PR 00717
Phone (787) 368-7802

917 Ave Tito Castro
Ponce, PR 00716
Phone (787) 560-4314

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1922395250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 336810",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007336810",
            "telephone_number": "787-844-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 TITO CASTRO AVE",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00716",
            "telephone_number": "787-844-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARIANA",
        "middle_name": "ISABEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "18611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.