Individual provider Active NPI

Glorissa Rodriguez-Feliciano, MD

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1932181708
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15033 Issued in PR
Practice address
1 Calle Tulipan Ba-22
Valle Arriba Heights
Carolina, PR 00983-1577
Phone
(787) 752-6505
Fax
(939) 337-7518
NPI assigned
Nov 17, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 15033 PR Primary

Addresses

Primary practice location

1 Calle Tulipan Ba-22
Valle Arriba Heights
Carolina, PR 00983-1577

Mailing address

Urb. Mans de Vistamar Marina
1119 Calle Marbella
Carolina, PR 00983-1577
Phone (939) 645-4250

Other identifiers 1

IdentifierTypeStateIssuer
15033OtherPRLICENSE

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
I20050131000473 PR Practitioner - General Practice 5799735486 Practice locations: Carolina, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Avenida Monserrate
22 Valle Arriba Heights
Carolina, PR 00983-1577
Phone (787) 752-6505

Marbella Este
1119 Mansiones de Vistamar Marina
Carolina, PR 00983-1577

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15033PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Agada, LLC General Practice PastSince Mar 3, 2024 Accepting new patients

Organizations & group practices 1

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1932181708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. MANS DE VISTAMAR MARINA",
            "address_2": "1119 CALLE MARBELLA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009831577",
            "telephone_number": "939-645-4250",
            "fax_number": "939-337-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CALLE TULIPAN BA-22",
            "address_2": "VALLE ARRIBA HEIGHTS",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009831577",
            "telephone_number": "787-752-6505",
            "fax_number": "939-337-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-FELICIANO",
        "first_name": "GLORISSA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "15033",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.