Individual provider Active NPI

Carlos Ruben Cardona Rodriguez, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1932698651
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
21567 Issued in PR
Practice address
1064 Ave Ponce de Leon
Suite 205
San Juan, PR 00907-3741
Phone
(787) 468-8050
NPI assigned
May 8, 2018
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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 21567 PR Primary

Addresses

Primary practice location

1064 Ave Ponce de Leon
Suite 205
San Juan, PR 00907-3741

Mailing address

1064 Ave Ponce de Leon
Suite 205
San Juan, PR 00907-3741
Phone (939) 223-7413

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
I20200908000041 PR Practitioner - General Practice 5597182568 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21567PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Collective CurrentSince Sep 14, 2025 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, 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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1932698651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 AVE PONCE DE LEON",
            "address_2": "SUITE 205",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009073741",
            "telephone_number": "939-223-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 AVE PONCE DE LEON",
            "address_2": "SUITE 205",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009073741",
            "telephone_number": "787-468-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA RODRIGUEZ",
        "first_name": "CARLOS",
        "middle_name": "RUBEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.