Individual provider Active NPI

Judith Teresa Palmer Bengoa, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1124075429
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14006 Issued in PR
Practice address
Cond. St. Marys Plaza
Torre Sur , Apt. 1601
San Juan, PR 00907
Phone
(787) 530-0888
Fax
(787) 754-1059
NPI assigned
May 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 14006 PR Primary

Addresses

Primary practice location

Cond. St. Marys Plaza
Torre Sur , Apt. 1601
San Juan, PR 00907

Mailing address

Cond St Marys Plaza
Torre Sur Apt. 1601
San Juan, PR 00907
Phone (787) 530-0888

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
I20031111000109 PR Practitioner - General Practice 3476466954 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Puerto Rico, P.S.C CurrentSince May 1, 2014 Accepting new patients
Grupo Medico Familiar General Practice Past Accepting new patients
Isabela Podiatry PSC PastSince Sep 5, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124075429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND ST MARYS PLAZA",
            "address_2": "TORRE SUR APT. 1601",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00907",
            "telephone_number": "787-530-0888",
            "fax_number": "787-754-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COND. ST. MARYS PLAZA",
            "address_2": "TORRE SUR , APT. 1601",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00907",
            "telephone_number": "787-530-0888",
            "fax_number": "787-754-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER BENGOA",
        "first_name": "JUDITH",
        "middle_name": "TERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.