Domingo Chardon, M.D.
Individual provider Active NPI Specialist · Ponce, PR
NPI 1104898733 · NPPES record last updated Dec 1, 2008
Key facts
- NPI
- 1104898733
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 9184 (PR)
- Practice address
- 917 Ave Tito Castro
Saint Lukes Memorial Hospital
Ponce, PR 00731-0000 - Phone
- (787) 844-0705
- Fax
- (787) 844-0706
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Pulmonary Disease
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Med Centro Inc
Practice addresses (Care Compare)
1034 Ave Hostos
Ponce, PR 00716-1115
Phone 78784393931025
909 Ave Tito Castro Torre Medica San
Suite 514
Ponce, PR 00716-4728
Phone (787) 844-0705
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101217000393 | PR | Practitioner - Pulmonary Disease |
9537104740 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9184 | PR | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute of Pulmonary Diseases CSP | Pulmonary Disease | Current |
Accepting new patients |
Locations
917 Ave Tito Castro
Ponce, PR 00716
Phone (787) 560-4314
909 Ave Tito Castro
Ste 514
Ponce, PR 00716
Phone (787) 844-0705
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 9184 | PR | Yes |
Addresses
Primary practice location
917 Ave Tito Castro
Saint Lukes Memorial Hospital
Ponce, PR 00731-0000
Mailing address
PO Box 518
Mercedita, PR 00715-0518
Phone (787) 844-0705
Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.