NPIMap

Organization Active NPI

Cardiomed LLC

  • Cardiovascular Disease Physician
  • San Juan, PR
National Provider Identifier
1104206028
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
18536 Issued in PR
Legal business name
CARDIOMED LLC
Practice address
1492 Ave Ponce de Leon Ste 717
San Juan, PR 00907-4024
Phone
(787) 723-5017
Fax
(787) 723-5015
NPI assigned
Jun 5, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Reynerio Eliezer Perez Ramirez, M.D.NPI 1003049289
Title
Sole Member
Phone
(787) 536-5976

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18536 PR
Cardiovascular Disease Physician 207RC0000X 18536 PR Primary

Addresses

Primary practice location

1492 Ave Ponce de Leon Ste 717
San Juan, PR 00907-4024

Mailing address

PO Box 11577
Fernandez Juncos Station
San Juan, PR 00910
Phone (787) 723-5017

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150803000791 PR Part B Supplier - Clinic/Group Practice 5890009948 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

1492 Ave Ponce de Leon
Ste 717
Santurce, PR 00907
Phone (787) 723-5015

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1104206028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11577",
            "address_2": "FERNANDEZ JUNCOS STATION",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00910",
            "telephone_number": "787-723-5017",
            "fax_number": "787-723-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 AVE PONCE DE LEON STE 717",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009074024",
            "telephone_number": "787-723-5017",
            "fax_number": "787-723-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOMED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PEREZ RAMIREZ",
        "authorized_official_first_name": "REYNERIO",
        "authorized_official_middle_name": "ELIEZER",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "787-536-5976",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "18536",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PR",
            "license": "18536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.