Individual provider Active NPI

Nitza Rodriguez, M.D.

  • Family Medicine Physician
  • Ponce, PR
National Provider Identifier
1982679726
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13924 Issued in PR
Practice address
Coliseo Shopping Center - Avenida Eduardo Ruberte
Suite 103
Ponce, PR 00728-1712
Phone
(787) 840-9708
Fax
(787) 840-9708
NPI assigned
Feb 22, 2006
Last updated
Feb 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13924 PR Primary

Addresses

Primary practice location

Coliseo Shopping Center - Avenida Eduardo Ruberte
Suite 103
Ponce, PR 00728-1712

Mailing address

Manuel Chelo Roman St
# 48
Adjuntas, PR 00601
Phone (787) 391-8076

Other identifiers 1

IdentifierTypeStateIssuer
13924OtherPRMEDICAL LICENSE

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
I20060420000452 PR Practitioner - Family Practice 4587673447 Reassigns benefits to 1 organization
Practice locations: Ponce, PR

Care Compare profile

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

Practice addresses (Care Compare)

Coliseo Shopping Ctr Aven Eduardo Ruberte
Suite 103
Ponce, PR 00728-1712

Coliseo Shopping Ctr Avenida Eduard
Suite 103
Ponce, PR 00728-1712
Phone (787) 840-9708

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NRT Family Medicine PSC Family Medicine CurrentSince Jul 7, 2014 Accepting new patients
Los Angeles Medical Health Clinic Family Medicine Past Accepting new patients
Policlinicas de Ponce Past Accepting new patients
Los Angeles Medical Clinic Corp Family Medicine Past 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, 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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1982679726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MANUEL CHELO ROMAN ST",
            "address_2": "# 48",
            "city": "ADJUNTAS",
            "state": "PR",
            "postal_code": "00601",
            "telephone_number": "787-391-8076",
            "fax_number": "787-840-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COLISEO SHOPPING CENTER - AVENIDA EDUARDO RUBERTE",
            "address_2": "SUITE 103",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007281712",
            "telephone_number": "787-840-9708",
            "fax_number": "787-840-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "NITZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "13924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "13924",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.