Individual provider Active NPI

Edwin I Perez Marrero, MD

  • Interventional Cardiology Physician
  • San Juan, PR
National Provider Identifier
1043203268
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
13945 Issued in PR
Practice address
Centro Cardiovascular de Puerto Rico Y El Caribe
Suite 8 B
San Juan, PR 00936-6528
Phone
(787) 771-3040
Fax
(787) 771-3044
NPI assigned
Aug 23, 2005
Last updated
Aug 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13945 PR
Internal Medicine Physician 207R00000X A108604 CA
Cardiovascular Disease Physician 207RC0000X 13945 PR
Interventional Cardiology Physician 207RI0011X 13945 PR Primary

Addresses

Primary practice location

Centro Cardiovascular de Puerto Rico Y El Caribe
Suite 8 B
San Juan, PR 00936-6528

Mailing address

PO Box 364903
San Juan, PR 00936-4903
Phone (787) 993-1366

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
I20100909000344 PR Practitioner - Cardiovascular Disease (Cardiology) 3375668734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carr 21 Barrio Monacillas
San Juan, PR 00927-3232
Phone (787) 767-9164

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting28
Leg revascularization (restoring blood flow)23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A108604CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Cardiologia Intervencional Y Periferovascular del Norte, PSC Interventional Cardiology CurrentSince Apr 9, 2012 Accepting new patients
Corporacion Centro Cardiovascular de Puerto Rico Y del Caribe Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1043203268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 364903",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009364903",
            "telephone_number": "787-993-1366",
            "fax_number": "787-993-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRO CARDIOVASCULAR DE PUERTO RICO Y EL CARIBE",
            "address_2": "SUITE 8 B",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009366528",
            "telephone_number": "787-771-3040",
            "fax_number": "787-771-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ MARRERO",
        "first_name": "EDWIN",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "13945",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A108604",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PR",
            "license": "13945",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PR",
            "license": "13945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.