Norberto Medina Pellicer, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1302 Issued in PR

Practice address

Laguna Gardens Shopping Center
Suite 200
Carolina, PR 00979

Phone

(787) 791-0906

Fax

(787) 791-6117

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Med Vec Dental CSP

  • General Practice Dentistry
  • Carolina, PR
  • NPI 1588795314
  NPD (past)
• Norberto Medina Pellicer

  • Dental Clinic/Center
  • Carolina, PR
  • NPI 1639319312
  NPD (past)
• Premium Professional Health Group PSC

  • Clinic/Center
  • Carolina, PR
  • NPI 1780902312
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083830970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAGUNA GARDENS SHOPPING CENTER",
            "address_2": "SUITE 200",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00979",
            "telephone_number": "787-791-0906",
            "fax_number": "787-791-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAGUNA GARDENS SHOPPING CENTER",
            "address_2": "SUITE 200",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00979",
            "telephone_number": "787-791-0906",
            "fax_number": "787-791-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA PELLICER",
        "first_name": "NORBERTO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medicine Internal Dra Sara Acevedo CSP
• Claudia Alejandra Medina Luna, PSICOLOGA
• Roberto Carlos Jesus Medina Matos, PHARMD
• Javier Medina Mendez
• Milane Somary Medina Ortiz, LND, MHSN, DE-PR
• Josiel Medina Zayas, M.D.
• Carlos Xavier Medina-Perez
• Ivelisse Medina
• Samuel Medina
• Zaida Medina, BA

• General Practice Dentistry in Carolina, PR
• Providers in Carolina, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.