Individual provider Active NPI

Antonio J Mattei Pacheco

  • Anesthesiology Physician
  • San Juan, PR
National Provider Identifier
1013989722
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
12267 Issued in PR
Practice address
150 Ave de Diego
Suite 300 Edif. San Juan Health Centre
San Juan, PR 00907-2300
Phone
(787) 729-0606
Fax
(787) 729-4242
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 12267 PR Primary

Addresses

Primary practice location

150 Ave de Diego
Suite 300 Edif. San Juan Health Centre
San Juan, PR 00907-2300

Mailing address

150 Ave de Diego
Suite 300 Edif. San Juan Health Centre
San Juan, PR 00907-2300
Phone (787) 729-0606

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
I20040713000573 PR Practitioner - Anesthesiology 3577541135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Puerto Rico School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anestesia 2000Group PAC ID 5799763355, 2 clinicians

Practice addresses (Care Compare)

150 Ave de Diego
Suite 300
San Juan, PR 00907-2322
Phone (787) 729-0606

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12267PRMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anestesia 2000 Anesthesiology CurrentSince Oct 7, 2002 Accepting new patients
Instituto de Podiatria Y Pie Diabetico de Puerto Rico Past Accepting new patients

Locations

100 Calle Betances
Caguas, PR 00725
Phone (787) 729-0606

1494 Ave Fd Roosevelt
Ste 101
San Juan, PR 00920
Phone (787) 729-0606

150 Ave de Diego
Ste 300
San Juan, PR 00907
Phone (787) 547-9834

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1013989722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 AVE DE DIEGO",
            "address_2": "SUITE 300 EDIF. SAN JUAN HEALTH CENTRE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009072300",
            "telephone_number": "787-729-0606",
            "fax_number": "787-729-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 AVE DE DIEGO",
            "address_2": "SUITE 300 EDIF. SAN JUAN HEALTH CENTRE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009072300",
            "telephone_number": "787-729-0606",
            "fax_number": "787-729-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTEI PACHECO",
        "first_name": "ANTONIO",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PR",
            "license": "12267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.