Individual provider Active NPI

Jeannette Toledo Rodriguez

  • Clinical Medical Laboratory
  • Hatillo, PR
National Provider Identifier
1932356987
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
764 Issued in PR
Practice address
HC 6 Box 10560
Hatillo, PR 00659-6638
Phone
(787) 820-3183
Fax
(787) 820-3183
NPI assigned
Aug 21, 2008
Last updated
Feb 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 764 PR Primary
Medical Laboratory Technician 246RM2200X 3304 PR

Addresses

Primary practice location

HC 6 Box 10560
Hatillo, PR 00659-6638

Mailing address

HC-6 Box10560
Hatillo, PR 00659
Phone (787) 820-3183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080904000709 PR Part B Supplier - Independent Clinical Laboratory 1254407836 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hatillo, PR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3304PRMDCounseling Psychologist
764PRMDSpeech-Language Pathologist

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, 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": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1932356987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC-6 BOX10560",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "00659",
            "telephone_number": "787-820-3183",
            "fax_number": "787-820-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 6 BOX 10560",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006596638",
            "telephone_number": "787-820-3183",
            "fax_number": "787-820-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLEDO RODRIGUEZ",
        "first_name": "JEANNETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-21",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "764",
            "primary": true
        },
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "PR",
            "license": "3304",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatillo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.