Individual provider Active NPI

Mario Edsiquio Sanchez del Campo, M.D.

  • General Practice Physician
  • Caguas, PR
National Provider Identifier
1093760522
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
13241 Issued in PR
Practice address
Ave. Luis Munoz Marin
Urb. Mariolga
Caguas, PR 00625
Phone
(787) 653-3434
NPI assigned
May 23, 2006
Last updated
Jun 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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 13241 PR Primary

Addresses

Primary practice location

Ave. Luis Munoz Marin
Urb. Mariolga
Caguas, PR 00625

Mailing address

135 Les Jardins
Trujillo Alto, PR 00976-2212
Phone (787) 748-6614

Other identifiers 1

IdentifierTypeStateIssuer
9-02609AOtherPRBLUE SHIELD PROVIDER

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
I20120712000355 PR Practitioner - Emergency Medicine 1557526845 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bella Vista Hospital Inc CurrentSince May 26, 2012 Accepting new patients
Centro Medico del Turabo Inc General Practice Current Accepting new patients
Centro Medico del Turabo Inc CurrentSince May 26, 2012 Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1093760522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 LES JARDINS",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009762212",
            "telephone_number": "787-748-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. LUIS MUNOZ MARIN",
            "address_2": "URB. MARIOLGA",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00625",
            "telephone_number": "787-653-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ DEL CAMPO",
        "first_name": "MARIO",
        "middle_name": "EDSIQUIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "13241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER",
            "identifier": "9-02609A",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.