Organization Active NPI

Grupo Pediatrico de Caguas CSP

  • Pediatric Adolescent Medicine Physician
  • Caguas, PR
National Provider Identifier
1043209745
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
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, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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.NPI 1376549790
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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20210119002381 PR Part B Supplier - Mass Immunization (Roster Biller Only) 9133532880 Practice locations: Caguas, PR

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.