Individual provider Active NPI

Edgar Hernandez Montalvo, M.D.

  • Nephrology Physician
  • Manati, PR
National Provider Identifier
1033469390
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
19610 Issued in PR
Practice address
411 Calle Hernandez Carrion
Manati, PR 00674
Phone
(787) 787-5151
NPI assigned
Sep 14, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 19610 PR Primary

Addresses

Primary practice location

411 Calle Hernandez Carrion
Manati, PR 00674

Mailing address

Urb Estancias de Manati
#147 Calle Dorado
Manati, PR 00674
Phone (787) 595-3315

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
I20171128003703 PR Practitioner - NephrologyPractitioner - Internal Medicine 1355657099 Reassigns benefits to 1 organization
Practice locations: Manati, PR

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Manati Professional Plaza Calle Herna
Suite 411
Manati, PR 00674
Phone (787) 854-4120

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Servicios Primarios de Salud Inc Nephrology CurrentSince Jul 30, 2025 Accepting new patients
Centro de Servicios Primarios de Salud,Inc. Current Accepting new patients
Centro de Servicios Primarios de Salud,Inc. CurrentSince Jul 30, 2025 Accepting new patients
Nefromd PSC. Nephrology PastSince Jul 24, 2022 Accepting new patients

Locations

3 Calle Antonio Alcazar
Florida, PR 00650
Phone (787) 822-2170

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1033469390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB ESTANCIAS DE MANATI",
            "address_2": "#147 CALLE DORADO",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-595-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CALLE HERNANDEZ CARRION",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-787-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ MONTALVO",
        "first_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PR",
            "license": "19610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.