Individual provider Active NPI

Marjorie Acosta-Guillot, M.D

  • General Practice Physician
  • Toa Alta, PR
National Provider Identifier
1013166107
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17279 Issued in PR
Practice address
L2 Calle 7
Toa Alta, PR 00953-2220
Phone
(787) 870-4704
NPI assigned
Sep 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17279 PR Primary

Addresses

Primary practice location

L2 Calle 7
Toa Alta, PR 00953-2220

Mailing address

Ep3 Calle Jose Mercado
Toa Baja, PR 00949-2814
Phone (787) 685-2853

Other practice location 1

E21 Camino De Begonias
Bayamon, PR 00961-3973
Phone (787) 685-2853

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
I20200908000085 PR Practitioner - General Practice 6709201767 Practice locations: Bayamon, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Liv Med General Practice PastSince Oct 2, 2022 Accepting new patients

Organizations & group practices 1

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": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1013166107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EP3 CALLE JOSE MERCADO",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009492814",
            "telephone_number": "787-685-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "L2 CALLE 7",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009532220",
            "telephone_number": "787-870-4704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "E21 Camino De Begonias",
            "address_purpose": "LOCATION",
            "city": "Bayamon",
            "state": "PR",
            "postal_code": "009613973",
            "country_code": "US",
            "telephone_number": "787-685-2853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACOSTA-GUILLOT",
        "first_name": "MARJORIE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-12",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Alta, PR

Sources for this page

Verify at the official NPI Registry.