Organization Active NPI

Policlinica del Caribe PSC

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1003218637
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5572 Issued in PR
Legal business name
POLICLINICA DEL CARIBE PSC
Practice address
41 Calle Piscis
Los Angeles
Carolina, PR 00979-1620
Phone
(787) 791-5712
Fax
(787) 253-3689
NPI assigned
Sep 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Dr. Jorge Luis Mendez Santiago, M.D.
Title
Presidente
Phone
(787) 791-5712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 5572 PR Primary

Addresses

Primary practice location

41 Calle Piscis
Los Angeles
Carolina, PR 00979-1620

Mailing address

PO Box 3677
Carolina, PR 00984-3677
Phone (787) 791-5712

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150303001804 PR Part B Supplier - Clinic/Group Practice 7810213162 Receives reassigned benefits from 1 practitioner
Practice locations: Carolina, PR

National Provider Directory

National Provider Directory

Locations

41 Calle Piscis
Carolina, PR 00979
Phone (787) 791-5712

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1003218637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3677",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009843677",
            "telephone_number": "787-791-5712",
            "fax_number": "787-253-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 CALLE PISCIS",
            "address_2": "LOS ANGELES",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009791620",
            "telephone_number": "787-791-5712",
            "fax_number": "787-253-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLICLINICA DEL CARIBE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "MENDEZ SANTIAGO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-791-5712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "5572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.