Individual provider Active NPI

Jaime Luis Rodriguez, M.D.

  • Child & Adolescent Psychiatry Physician
  • Villalba, PR
National Provider Identifier
1982852489
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
18240 Issued in PR
Practice address
HC 2 Box 4948
Villalba, PR 00766-9718
Phone
(787) 377-1277
NPI assigned
Sep 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 18240 PR
Psychiatry Physician 2084P0800X 18240 PR
Child & Adolescent Psychiatry Physician 2084P0804X 18240 PR Primary

Addresses

Primary practice location

HC 2 Box 4948
Villalba, PR 00766-9718

Mailing address

HC 2 Box 4948
Villalba, PR 00766-9718
Phone (787) 377-1277

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
I20120727000103 PR Practitioner - Psychiatry 9830355387 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18240PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Behavioral Care Corp. CurrentSince Jun 22, 2019 Accepting new patients
Inspira Behavioral Care Corp. Current Accepting new patients
Inspira Behavioral Care Corp CurrentSince Jun 22, 2019 Accepting new patients
Serenity Integrated Medical Group PSC Psychiatry CurrentSince Nov 1, 2023 Accepting new patients
Inspira Mental Health Management PastSince Jun 22, 2019 Accepting new patients
Inspira Behavioral Care Corp. Past Accepting new patients

Locations

1123 Ave Hostos
Ponce, PR 00717
Phone (787) 377-1277

55 Calle Comercio
Yauco, PR 00698
Phone (787) 267-1810

Organizations & group practices 6

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": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1982852489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 2 BOX 4948",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "007669718",
            "telephone_number": "787-377-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 2 BOX 4948",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "007669718",
            "telephone_number": "787-377-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JAIME",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18240",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "18240",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PR",
            "license": "18240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villalba, PR

Sources for this page

Verify at the official NPI Registry.