NPIMap

Individual provider Active NPI

Joanne M Marin, MD.

  • Diagnostic Radiology Physician
  • Hato Rey, PR
National Provider Identifier
1003844986
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11095 Issued in PR
Practice address
Ave. Roosevelt
156
Hato Rey, PR 00918
Phone
(787) 754-1422
Fax
(787) 754-8555
NPI assigned
Jun 29, 2006
Last updated
Sep 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 11095 PR
Diagnostic Radiology Physician 2085R0202X 11095 PR Primary
Diagnostic Ultrasound Physician 2085U0001X 11095 PR

Addresses

Primary practice location

Ave. Roosevelt
156
Hato Rey, PR 00918

Mailing address

1353 Ave Luis Vigoreaux
PMB 647
Guaynabo, PR 00966-2715
Phone (787) 754-1422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401000846 PR Practitioner - Diagnostic Radiology 7911999677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Puerto Rico School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

156 Ave FD Roosevelt
San Juan, PR 00918-2406
Phone (787) 754-1422

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11095PRMDDiagnostic Ultrasound Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HPM Foundation Inc CurrentSince Apr 6, 2020 Accepting new patients
Hato Rey X-Ray and Imaging Center Inc. CurrentSince Aug 10, 2024 Accepting new patients
Bayamon SMH Corporation Diagnostic Radiology CurrentSince Oct 1, 2001 Accepting new patients
Los Angeles Medical Health Clinic Past Accepting new patients
Diagnostic Imaging Center, PSC Past Accepting new patients
CT Radiology Complex, LLC Body Imaging Past Accepting new patients
MD Radiology Services PSC Past Accepting new patients
MD Radiological Services, PSC Past Accepting new patients
Joanne Marin Favale PSC Past Accepting new patients
Los Angeles Medical Clinic Corp Past Accepting new patients

Locations

1353 Ave Luis Vigoreaux
Guaynabo, PR 00966

35 Calle Juan C Borbon
Ste 67
Guaynabo, PR 00969
Phone (787) 287-0353

156 Ave Fd Roosevelt
San Juan, PR 00918
Phone (787) 754-1422

2020 Ave Borinquen
Santurce, PR 00915

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGBCCA/Endpoint/BGBCCA

Organizations & group practices 11

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1003844986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 AVE LUIS VIGOREAUX",
            "address_2": "PMB 647",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662715",
            "telephone_number": "787-754-1422",
            "fax_number": "787-754-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. ROOSEVELT",
            "address_2": "156",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-754-1422",
            "fax_number": "787-754-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "JOANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "PR",
            "license": "11095",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PR",
            "license": "11095",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "PR",
            "license": "11095",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hato Rey, PR

Sources for this page

Verify at the official NPI Registry.