Individual provider Active NPI

Linette Bosques Vargas, FAAP

  • Pediatrics Physician
  • Manati, PR
National Provider Identifier
1124471743
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
21011 Issued in PR
Practice address
Manati Medical Center
Manati, PR 00674
Phone
(787) 631-3700
NPI assigned
Jul 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 21011 PR
Student in an Organized Health Care Education/Training Program 390200000X 14235I PR
Pediatrics Physician 208000000X 21011 PR Primary

Addresses

Primary practice location

Manati Medical Center
Manati, PR 00674

Mailing address

Urb Sabanera Dorado
Camino de la Torre 620
Dorado, PR 00646-8395
Phone (939) 630-5413

Other practice location 1

HC 2 Box 12260
Moca, PR 00676-8395
Phone (939) 630-5413

Other identifiers 1

IdentifierTypeStateIssuer
21011OtherLICENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21011PRMDGeneral Practice Physician
14235IPRMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
SHC Owner LLC Past Accepting new patients
The San Jorge Hospital Inc Past Accepting new patients

Organizations & group practices 2

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": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1124471743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB SABANERA DORADO",
            "address_2": "CAMINO DE LA TORRE 620",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006468395",
            "telephone_number": "939-630-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MANATI MEDICAL CENTER",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-631-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "HC 2 Box 12260",
            "address_purpose": "LOCATION",
            "city": "Moca",
            "state": "PR",
            "postal_code": "006768395",
            "country_code": "US",
            "telephone_number": "939-630-5413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSQUES VARGAS",
        "first_name": "LINETTE",
        "credential": "FAAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2021-06-08",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21011",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "14235I",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "21011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "21011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.