Individual provider Active NPI

Lourdes Petrilli, RPT

  • Physical Therapist
  • San Juan, PR
National Provider Identifier
1063495398
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
516 Issued in PR
Practice address
979 Calle Yaboa Real
Urb. Country Club
San Juan, PR 00924-3350
Phone
(787) 750-6725
Fax
(787) 750-6725
NPI assigned
Nov 21, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 516 PR Primary

Addresses

Primary practice location

979 Calle Yaboa Real
Urb. Country Club
San Juan, PR 00924-3350

Mailing address

979 Calle Yaboa Real
Urb. Country Club
San Juan, PR 00924-3350
Phone (787) 750-6725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080612000861 PR Practitioner - Physical Therapist in Private Practice 2769383678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

PO Box
Suite 1449
Luquillo, PR 00773

St 193 KM
0 Suite 4 Playa Azul Center
Luquillo, PR 00773
Phone (787) 889-6012

St 193 KM
0 Suite 4 Playa Azul Center
Luquillo, PR 00773-1449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine Consultants Centro Fisiatrico del Caribe CurrentSince Apr 23, 2020 Accepting new patients
Physical Therapy and Rehabilitation Center 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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063495398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "979 CALLE YABOA REAL",
            "address_2": "URB. COUNTRY CLUB",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009243350",
            "telephone_number": "787-750-6725",
            "fax_number": "787-750-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 CALLE YABOA REAL",
            "address_2": "URB. COUNTRY CLUB",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009243350",
            "telephone_number": "787-750-6725",
            "fax_number": "787-750-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLI",
        "first_name": "LOURDES",
        "name_prefix": "Mrs.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "516",
            "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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.