Active NPI
Mercedes Fuste, DMD
- General Practice Dentistry
- San Juan, PR
National Provider Identifier
1023187010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D 1422
- Practice address
- 65 Inf. Ave. K3 H4
San Juan Aging Center
San Juan, PR 00924 - Phone
- (787) 480-5402
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D 1422 | PR | Primary |
Addresses
Primary practice location
65 Inf. Ave. K3 H4
San Juan Aging Center
San Juan, PR 00924
Mailing address
579 Calle Garfield
San Juan, PR 00926-5615
Phone (787) 653-2377
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170216000753 | PR | Order and Referring Only - Dentist | 7618250622 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D 1422 | PR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285545600000",
"number": "1023187010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "579 CALLE GARFIELD",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009265615",
"telephone_number": "787-653-2377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 INF. AVE. K3 H4",
"address_2": "SAN JUAN AGING CENTER",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00924",
"telephone_number": "787-480-5402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSTE",
"first_name": "MERCEDES",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2010-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PR",
"license": "D 1422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
- Ileana Mercedes Fumero, M.D.
- Jose Roberto Fumero, MD
- Fundacion de Investigacion de Diego (Fundacion de Investigacion)
- Fundacion Oncology Network LLC
- Fundacion Pediatrica de Diabetes
- Frances Zadette Fuster Astor, MD
- Andrea Fuster, DC
- Iris Fuster, LICENSEDPSYCHOLOGIST
- Jaime L. Fuster, M.D.
- Michelle M Fuster, MS, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.