Organization Active NPI

Endocrinology and Diabetes Wellness Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Manati, PR
National Provider Identifier
1023588514
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ENDOCRINOLOGY AND DIABETES WELLNESS CENTER
Practice address
Urb Atenas Hernandez Carrion Oficina 213
Manati Medical Center Professional Plaza
Manati, PR 00674-0001
Phone
(787) 621-4828
NPI assigned
Nov 28, 2018
Last updated
May 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
Naomi Collazo Gutierrez, MDNPI 1225427651
Title
President
Phone
(787) 447-5200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X Primary

Addresses

Primary practice location

Urb Atenas Hernandez Carrion Oficina 213
Manati Medical Center Professional Plaza
Manati, PR 00674-0001

Mailing address

118 Ave Carlos Chardon Cond Quantum Metrocenter
Apt 150
San Juan, PR 00918
Phone (787) 447-5200

Other practice location 1

Hospital Manati Medical Center
Urb. Atenas Calle Hernandez Carrion #668
Manati, PR 00674
Phone (787) 621-3700

Other practice location 2

Jose C Vazquez #13
Aibonito, PR 00705
Phone (787) 378-2786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190528000207 PR Part B Supplier - Clinic/Group Practice 7416290820 Receives reassigned benefits from 3 practitioners
Practice locations: Aibonito, PR; Manati, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1023588514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 AVE CARLOS CHARDON COND QUANTUM METROCENTER",
            "address_2": "APT 150",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-447-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB ATENAS HERNANDEZ CARRION OFICINA 213",
            "address_2": "MANATI MEDICAL CENTER PROFESSIONAL PLAZA",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740001",
            "telephone_number": "787-621-4828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "HOSPITAL MANATI MEDICAL CENTER",
            "address_2": "URB. ATENAS CALLE HERNANDEZ CARRION #668",
            "address_purpose": "LOCATION",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "country_code": "US",
            "telephone_number": "787-621-3700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Jose C Vazquez #13",
            "address_purpose": "LOCATION",
            "city": "Aibonito",
            "state": "PR",
            "postal_code": "00705",
            "country_code": "US",
            "telephone_number": "787-378-2786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENDOCRINOLOGY AND DIABETES WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-28",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "COLLAZO GUTIERREZ",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-447-5200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.