Individual provider Active NPI

Wanda I Almodovar, M. D.

  • Internal Medicine Physician
  • Yauco, PR
National Provider Identifier
1093093635
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18617 Issued in PR
Practice address
13B Calle Baldorioty
Yauco, PR 00698-3654
Phone
(787) 673-7431
NPI assigned
Aug 1, 2011
Last updated
Mar 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18617 PR Primary

Addresses

Primary practice location

13B Calle Baldorioty
Yauco, PR 00698-3654

Mailing address

PO Box 1351
Yauco, PR 00698-1351

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
I20150929000664 PR Practitioner - Internal Medicine 4981912714 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Longevity Nutrition Services, LLC Single Specialty CurrentSince Dec 3, 2023 Accepting new patients
Esperanza MD LLC Single Specialty CurrentSince Feb 1, 2023 Accepting new patients
J.C. Island Lithotripsy LLC Single Specialty Past Accepting new patients

Locations

13B Calle Baldorioty
Yauco, PR 00698
Phone (787) 235-7013

Organizations & group practices 3

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": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1093093635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1351",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006981351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13B CALLE BALDORIOTY",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006983654",
            "telephone_number": "787-673-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALMODOVAR",
        "first_name": "WANDA",
        "middle_name": "I",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "18617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yauco, PR

Sources for this page

Verify at the official NPI Registry.