Active NPI
Grupo Pediatrico de Caguas CSP
- Pediatric Adolescent Medicine Physician
- Caguas, PR
National Provider Identifier
1043209745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- Legal business name
- GRUPO PEDIATRICO DE CAGUAS CSP
- Practice address
- 50 Ave Munoz Marin
Quadrangle Medical Center 307
Caguas, PR 00725-3975 - Phone
- (787) 746-2021
- Fax
- (787) 746-4248
- NPI assigned
- Oct 17, 2005
- Last updated
- Mar 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Fernando J. Ysern Borras, M.D.
- Title
- Partner
- Phone
- (787) 746-2021
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | PR | Primary |
Addresses
Primary practice location
50 Ave Munoz Marin
Quadrangle Medical Center 307
Caguas, PR 00725-3975
Mailing address
PO Box 8969
Caguas, PR 00726-8969
Phone (787) 746-2021
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210119002381 | PR | Part B Supplier - Mass Immunization (Roster Biller Only) | 9133532880 | Practice locations: Caguas, PR |
National Provider Directory
National Provider DirectoryLocations
50 Ave Luis Munoz Marin
Ste 307
Caguas, PR 00725
Phone (787) 586-9154
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.
-
- Pediatrics Physician
- Caguas, PR
- NPI 1174528665
-
- Pediatrics Physician
- Caguas, PR
- NPI 1225222615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1237161600000",
"number": "1043209745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8969",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007268969",
"telephone_number": "787-746-2021",
"fax_number": "787-746-4248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 AVE MUNOZ MARIN",
"address_2": "QUADRANGLE MEDICAL CENTER 307",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007253975",
"telephone_number": "787-746-2021",
"fax_number": "787-746-4248"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRUPO PEDIATRICO DE CAGUAS CSP",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-17",
"last_updated": "2009-03-16",
"status": "A",
"authorized_official_last_name": "YSERN BORRAS",
"authorized_official_first_name": "FERNANDO",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "787-746-2021",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "PR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Caguas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; 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.