Individual provider Active NPI

Myreliz Casillas Mangual, DC

  • Chiropractor
  • Canovanas, PR
National Provider Identifier
1083334536
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
854 Issued in PR
Practice address
Carretera 958 MK 5.7 Palmasola
Canovanas, PR 00729-0013
Phone
(787) 313-1607
NPI assigned
Sep 2, 2022
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 854 PR Primary

Addresses

Primary practice location

Carretera 958 MK 5.7 Palmasola
Canovanas, PR 00729-0013

Mailing address

PO Box 30000
Canovanas, PR 00729-0013
Phone (787) 313-1607

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221219000068 PR Practitioner - Chiropractic 3577932342 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
University Central del Caribe Escuela de Medicina, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Carr 190
8 Sabana Abajo
Carolina, PR 00983-7401
Phone (787) 789-1996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
854PRMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Las Americas Guaynabo, Inc Chiropractor Current Accepting new patients
Clinica Las Americas Guaynabo, Inc CurrentSince Dec 1, 2022 Accepting new patients
Clinica Las Americas Guaynabo, Inc Chiropractor CurrentSince Dec 1, 2022 Accepting new patients
Chiropractic Spine Solutions LLC Chiropractor CurrentSince Mar 1, 2024 Accepting new patients

Locations

1 Ave Casa Linda
Bayamon, PR 00959

1 Ave Casa Linda
Ste 101
Bayamon, PR 00959
Phone (787) 399-9092

C1 Ave a Perez Andino
Rio Grande, PR 00745
Phone (787) 313-1607

Organizations & group practices 4

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": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1083334536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30000",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007290013",
            "telephone_number": "787-313-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 958 MK 5.7 PALMASOLA",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007290013",
            "telephone_number": "787-313-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASILLAS MANGUAL",
        "first_name": "MYRELIZ",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canovanas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.