Individual provider Active NPI

Irma Ponce de Leon Rosado

  • Physical Therapist
  • Yauco, PR
National Provider Identifier
1962629154
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0731 Issued in PR
Practice address
42 Mattei Lluberas
Suite 1
Yauco, PR 00698
Phone
(787) 856-5272
Fax
(787) 856-8421
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0731 PR Primary

Addresses

Primary practice location

42 Mattei Lluberas
Suite 1
Yauco, PR 00698

Mailing address

42 Mattei Lluberas
Suite 1
Yauco, PR 00698
Phone (787) 856-5272

Other identifiers 1

IdentifierTypeStateIssuer
0084104OtherPRREFORMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120315000018 PR Practitioner - Physical Therapist in Private Practice 2365601176 Practice locations: Yauco, PR

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

42 Calle Mattei Lluberas
Suite 1
Yauco, PR 00698-3630
Phone (787) 856-5272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
257PRMDOptometrist
731PRMDOptician
0731PRMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabibilitacion Ponce de Leon Clinica de Terapia Fisica Physical Therapist Past Accepting new patients
Centro Fisiatrico del Caribe PSC Past Accepting new patients

Organizations & group practices 2

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1962629154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 MATTEI LLUBERAS",
            "address_2": "SUITE 1",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "00698",
            "telephone_number": "787-856-5272",
            "fax_number": "787-856-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 MATTEI LLUBERAS",
            "address_2": "SUITE 1",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "00698",
            "telephone_number": "787-856-5272",
            "fax_number": "787-856-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE DE LEON ROSADO",
        "first_name": "IRMA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "0731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REFORMA",
            "identifier": "0084104",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yauco, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.