Marta Teresa Irizarry-Egipciaco, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1613-PA Issued in PR

Practice address

528 Ave Cesar Gonzalez
Esq. Ave Domenech
San Juan, PR 00918

Phone

(787) 248-0398

NPI assigned

Oct 12, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1083495337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 CESAR GONZALEZ ESQ. AVE. DOMENECH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-248-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 AVE CESAR GONZALEZ",
            "address_2": "ESQ. AVE DOMENECH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-248-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRIZARRY-EGIPCIACO",
        "first_name": "MARTA",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "1613-PA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mara Isabel Irizarry Hernandez, M.S.
• Ileana Irizarry Medina, M.D.
• Eduardo Andres Irizarry Nieves, M.D.
• Luis Enrique Irizarry Nieves, MD
• Mariana Gabriela Irizarry Torres
• Emily Enid Irizarry-Pagan, M.D.
• Astrid E Irizarry
• Caroline M. Irizarry, MSW
• Emily Irizarry, MD
• Gladys M Irizarry, M.D.

• Medical Physician Assistant in San Juan, PR
• Providers in San Juan, PR by specialty
• Medical Physician Assistant in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.