Advanced Care Internal Medicine L.L.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA060596 Issued in NJ

Legal business name

ADVANCED CARE INTERNAL MEDICINE L.L.C.

Practice address

751 Garnet LN
East Stroudsburg, PA 18301-8495

Phone

(973) 900-0471

Fax

(570) 730-4415

NPI assigned

Dec 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jose Nicolas Fuentes, M.D.

Title

President

Phone

(973) 900-0471

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365120000000",
    "number": "1003978347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 GARNET LN",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018495",
            "telephone_number": "973-900-0471",
            "fax_number": "570-730-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 GARNET LN",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018495",
            "telephone_number": "973-900-0471",
            "fax_number": "570-730-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CARE INTERNAL MEDICINE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2013-04-05",
        "status": "A",
        "authorized_official_last_name": "FUENTES",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "NICOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-900-0471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA060596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.