Individual provider Active NPI

Angela I Feliciano Caraballo, FNP

  • Nurse Practitioner
  • San Juan, PR
National Provider Identifier
1053938480
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3420 Issued in PR
Practice address
10 C. Casia, San Juan
San Juan, PR 00921
Phone
(787) 641-7582
NPI assigned
Jul 1, 2020
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nurse Practitioner 363L00000X 3420 PR Primary

Addresses

Primary practice location

10 C. Casia, San Juan
San Juan, PR 00921

Mailing address

HC 5 Box 7299
Yauco, PR 00698-9721
Phone (787) 397-6495

Other practice location 1

100 Ave Luis Munoz Marin
Caguas, PR 00725-6184
Phone (787) 653-3434 ext. 1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3420PRMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1053938480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 5 BOX 7299",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006989721",
            "telephone_number": "787-397-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 C. CASIA, SAN JUAN",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00921",
            "telephone_number": "787-641-7582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Ave Luis Munoz Marin",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "007256184",
            "country_code": "US",
            "telephone_number": "787-653-3434 x1511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELICIANO CARABALLO",
        "first_name": "ANGELA",
        "middle_name": "I",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PR",
            "license": "3420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.