NPIMap

Organization Active NPI

Pediatrix Medical Group

  • Pediatric Nephrology Physician
  • San Juan, PR
National Provider Identifier
1114122900
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
9989 Issued in PR
Legal business name
PEDIATRIX MEDICAL GROUP
Practice address
Pda 37 Ave Ponce de Leon
San Juan, PR 00902
Phone
(787) 758-2000
Fax
(787) 758-8519
NPI assigned
Jun 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Doris Saure
Title
Billing Manager
Phone
(787) 999-0753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 9989 PR Primary

Addresses

Primary practice location

Pda 37 Ave Ponce de Leon
San Juan, PR 00902

Mailing address

PO Box 3916
Guaynabo, PR 00970-3916
Phone (787) 999-0753

National Provider Directory

National Provider Directory
Tax ID family
Pediatrix Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114122900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3916",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009703916",
            "telephone_number": "787-999-0753",
            "fax_number": "787-999-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PDA 37 AVE PONCE DE LEON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00902",
            "telephone_number": "787-758-2000",
            "fax_number": "787-758-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIX MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAURE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "787-999-0753"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "PR",
            "license": "9989",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.