NPIMap

Organization Active NPI

P.J.M. Surgical, P.S.C.

  • Specialist
  • Mayaguez, PR
National Provider Identifier
1053516195
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
11240 Issued in PR
Legal business name
P.J.M. SURGICAL, P.S.C.
Practice address
351 Ave Hostos
Edif Medical Emporium #209
Mayaguez, PR 00680-1502
Phone
(787) 805-3232
NPI assigned
Jun 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gustavo Adolfo Colberg, M.D.NPI 1215047840
Title
Plastic Surgeon
Phone
(787) 805-3232

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 11240 PR Primary

Addresses

Primary practice location

351 Ave Hostos
Edif Medical Emporium #209
Mayaguez, PR 00680-1502

Mailing address

PO Box 901
Cabo Rojo, PR 00623-0901
Phone (787) 805-8140

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053516195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 901",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "006230901",
            "telephone_number": "787-805-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 AVE HOSTOS",
            "address_2": "EDIF MEDICAL EMPORIUM #209",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801502",
            "telephone_number": "787-805-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.J.M. SURGICAL, P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLBERG",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_middle_name": "ADOLFO",
        "authorized_official_title_or_position": "PLASTIC SURGEON",
        "authorized_official_telephone_number": "787-805-3232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "11240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.