Individual provider Active NPI

Maria de Los Angeles Renta-Soto, M.D.

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1073869368
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
28980-R Issued in PR
Practice address
Urb Camino del Sur 421
Ruisenor
Ponce, PR 00716-2826
Phone
(787) 475-4397
NPI assigned
Jul 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 28980-R PR Primary

Addresses

Primary practice location

Urb Camino del Sur 421
Ruisenor
Ponce, PR 00716-2826

Mailing address

Urb Camino del Sur 421
Ruisenor
Ponce, PR 00716-2826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150612001995 PR Practitioner - General Practice 9436460789 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28980-RPRMDGeneral Practice Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1073869368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB CAMINO DEL SUR 421",
            "address_2": "RUISENOR",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB CAMINO DEL SUR 421",
            "address_2": "RUISENOR",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162826",
            "telephone_number": "787-475-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTA-SOTO",
        "first_name": "MARIA DE LOS",
        "middle_name": "ANGELES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "28980-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.