Individual provider Active NPI

Domingo Chardon, M.D.

  • Specialist
  • Ponce, PR
National Provider Identifier
1104898733
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9184 Issued in 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
Last updated
Dec 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9184 PR Primary

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

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
I20101217000393 PR Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 9537104740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Centro IncGroup PAC ID 5890692131, shared by 8 NPIs, 62 clinicians

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Institute of Pulmonary Diseases CSP Pulmonary Disease CurrentSince May 12, 2008 Accepting new patients

Locations

909 Ave Tito Castro
Ste 514
Ponce, PR 00716
Phone (787) 844-0705

917 Ave Tito Castro
Ponce, PR 00716
Phone (787) 560-4314

Organizations & group practices 1

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1104898733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "MERCEDITA",
            "state": "PR",
            "postal_code": "007150518",
            "telephone_number": "787-844-0705",
            "fax_number": "787-844-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 AVE TITO CASTRO",
            "address_2": "SAINT LUKES MEMORIAL HOSPITAL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007310000",
            "telephone_number": "787-844-0705",
            "fax_number": "787-844-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARDON",
        "first_name": "DOMINGO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "9184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.