Individual provider Active NPI

Carla Tamayo, MD

  • Internal Medicine Physician
  • Mayaguez, PR
National Provider Identifier
1063969012
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21597 Issued in PR
Practice address
2 Calle Mendez Vigo W
Ste 3D
Mayaguez, PR 00680-4983
Phone
(787) 834-2800
Fax
(443) 557-3178
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A156932 CA
Internal Medicine Physician 207R00000X 21597 PR Primary

Addresses

Primary practice location

2 Calle Mendez Vigo W
Ste 3D
Mayaguez, PR 00680-4983

Mailing address

PO Box 1660
Mayaguez, PR 00681-1660
Phone (787) 918-7045

Other practice location 1

Cond. Ciudadela, 1511 Ave de la Constitucion
Suite 3
San Juan, PR 00909
Phone (787) 339-2639

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A156932CAMDInternal Medicine Physician
21597PRMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: carla.tamayo@54618109378564.direct.elationemr.com

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1063969012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1660",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006811660",
            "telephone_number": "787-918-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CALLE MENDEZ VIGO W",
            "address_2": "STE 3D",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006804983",
            "telephone_number": "787-834-2800",
            "fax_number": "443-557-3178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Cond. Ciudadela, 1511 Ave de la Constitucion",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00909",
            "country_code": "US",
            "telephone_number": "787-339-2639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAMAYO",
        "first_name": "CARLA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2022-01-11",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A156932",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "21597",
            "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 Jan 11, 2022; 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.