Individual provider Active NPI

Jose Raul Rodriguez, MD

  • General Practice Physician
  • Caguas, PR
National Provider Identifier
1972255388
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22986 Issued in PR
Practice address
170 Urb Caguas Real
Caguas, PR 00725-9054
Phone
(787) 344-8267
NPI assigned
Jan 26, 2022
Sex
Male
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 22986 PR Primary

Addresses

Primary practice location

170 Urb Caguas Real
Caguas, PR 00725-9054

Mailing address

170 Urb Caguas Real
Caguas, PR 00725-9054
Phone (787) 344-8267

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
I20230502001292 PR Practitioner - General Practice 0840655692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neomed Center, IncGroup PAC ID 1850284100, 66 clinicians

Practice addresses (Care Compare)

11 Calle Condado
San Lorenzo, PR 00754-4214
Phone (787) 715-1260

Ctro de Med de Fam
11 C Condado
San Lorenzo, PR 00754-4214
Phone (787) 715-3620

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22986PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neomed Center, Inc Current Accepting new patients
Neomed Center, Inc Single Specialty CurrentSince May 14, 2024 Accepting new patients
Neomed Center, Inc. CurrentSince May 14, 2024 Accepting new patients
Tiger Med Corp Single Specialty CurrentSince Jan 3, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1972255388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 URB CAGUAS REAL",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007259054",
            "telephone_number": "787-344-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 URB CAGUAS REAL",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007259054",
            "telephone_number": "787-344-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "RAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "22986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.