Organization Active NPI

MM Rheumatology LLC

  • Rheumatology Physician
  • Carolina, PR
National Provider Identifier
1063889202
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
17,950 Issued in PR
Legal business name
MM RHEUMATOLOGY LLC
Practice address
4Es5 Fragoso Ave.
Carolina, PR 00983-0000
Phone
(787) 768-8944
NPI assigned
Aug 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Dr. Melisa Martinez Marti, M.D.NPI 1235323668
Title
President
Phone
(787) 768-8944

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
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X 17,950 PR Primary

Addresses

Primary practice location

4Es5 Fragoso Ave.
Carolina, PR 00983-0000

Mailing address

PO Box 79594
Carolina, PR 00984-9594
Phone (787) 768-8944

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151204001736 PR Part B Supplier - Clinic/Group Practice 9436459971 Receives reassigned benefits from 1 practitioner
Practice locations: Carolina, PR

National Provider Directory

National Provider Directory

Locations

1400 Ave de Diego
Ste 240
Carolina, PR 00987
Phone (787) 253-1101

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": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1063889202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79594",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009849594",
            "telephone_number": "787-768-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4ES5 FRAGOSO AVE.",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009830000",
            "telephone_number": "787-768-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MM RHEUMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ MARTI",
        "authorized_official_first_name": "MELISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-768-8944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PR",
            "license": "17,950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.