Individual provider Active NPI

Soan Gily Cruz Ortiz, M.D.

  • Obstetrics & Gynecology Physician
  • San Juan, PR
National Provider Identifier
1053540823
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
18614 Issued in PR
Practice address
611 Calle Pavia Ste 203
San Juan, PR 00909-2242
Phone
(787) 433-2526
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 18614 PR Primary

Addresses

Primary practice location

611 Calle Pavia Ste 203
San Juan, PR 00909-2242

Mailing address

120 Ave Carlos Chardon Apt 129
San Juan, PR 00918-1721
Phone (787) 307-0741

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
I20140213000660 PR Practitioner - Obstetrics/Gynecology 1456594621 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

611 Calle Pavia
Suite 203
San Juan, PR 00909-2242
Phone (787) 307-0741

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18614PRMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MP-CC PC Past Accepting new patients
Municipality of San Juan PR 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.

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1053540823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 AVE CARLOS CHARDON APT 129",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009181721",
            "telephone_number": "787-307-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 CALLE PAVIA STE 203",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092242",
            "telephone_number": "787-433-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ ORTIZ",
        "first_name": "SOAN",
        "middle_name": "GILY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PR",
            "license": "18614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.