Individual provider Active NPI

Elena M Nogales Perez, MD

  • Dermatology Physician
  • Carolina, PR
National Provider Identifier
1003079757
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
18204 Issued in PR
Practice address
PQ26 Ave Comandante
Country Club
Carolina, PR 00983-0000
Phone
(787) 752-3280
Fax
(787) 752-8920
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 18204 PR Primary

Addresses

Primary practice location

PQ26 Ave Comandante
Country Club
Carolina, PR 00983-0000

Mailing address

#2023 Calle Aberdeen
Collegeville
Guaynabo, PR 00969-0000
Phone (787) 241-2982

Other identifiers 1

IdentifierTypeStateIssuer
18204OtherPRLICENSE

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
I20110811000755 PR Practitioner - Dermatology 6305015173 Reassigns benefits to 1 organization
Practice locations: Fajardo, PR

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Puerto Rico School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

410 Ave General Valero
Suite 402
Fajardo, PR 00738-3992
Phone (787) 860-4500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions442
Skin biopsy258

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advancedermatology and Skin Cancer Center, 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, 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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1003079757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#2023 CALLE ABERDEEN",
            "address_2": "COLLEGEVILLE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009690000",
            "telephone_number": "787-241-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PQ26 AVE COMANDANTE",
            "address_2": "COUNTRY CLUB",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009830000",
            "telephone_number": "787-752-3280",
            "fax_number": "787-752-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOGALES PEREZ",
        "first_name": "ELENA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PR",
            "license": "18204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "18204",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.