Active NPI
Mary Fonseca, PTA
- Physical Therapy Assistant
- Bayamon, PR
National Provider Identifier
1073177671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 738
- Practice address
- Carr 2 KM 8.5
Bo Juan Sanchez
Bayamon, PR 00960 - Phone
- (787) 782-8250
- NPI assigned
- Apr 29, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 738 | PR | Primary |
Addresses
Primary practice location
Carr 2 KM 8.5
Bo Juan Sanchez
Bayamon, PR 00960
Mailing address
Ciudad Interamericana
F14 Calle Jurel 645
Bayamon, PR 00956
Phone (787) 447-6574
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
| License | State | Type | Specialty |
|---|---|---|---|
| 738 | PR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556496000000",
"number": "1073177671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CIUDAD INTERAMERICANA",
"address_2": "F14 CALLE JUREL 645",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00956",
"telephone_number": "787-447-6574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 2 KM 8.5",
"address_2": "BO JUAN SANCHEZ",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00960",
"telephone_number": "787-782-8250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONSECA",
"first_name": "MARY",
"name_prefix": "Ms.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-29",
"last_updated": "2019-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PR",
"license": "738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayamon, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.