Individual provider Active NPI

Emmanuel Lopez Nogueras, MD

  • Anesthesiology Physician
  • San Juan, PR
National Provider Identifier
1124531819
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
22699 Issued in PR
Practice address
150 Ave. de Diego
Suite 300, Edif. San Juan Health Centre
San Juan, PR 00907-3714
Phone
(787) 729-0606
NPI assigned
Nov 16, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 22699 PR
Anesthesiology Physician 207L00000X 22699 PR Primary

Addresses

Primary practice location

150 Ave. de Diego
Suite 300, Edif. San Juan Health Centre
San Juan, PR 00907-3714

Mailing address

1105 Calle Bayona
San Juan, PR 00920-4039
Phone (787) 547-9834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230428002503 PR Practitioner - Anesthesiology 1153786991 Reassigns benefits to 1 organization
I20230914002897 IL Practitioner - Pain Management 1153786991 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22699PRMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Anesthesiology CurrentSince Jul 1, 2023 Accepting new patients
Hospitalist Medical Services, PSC Anesthesiology Current Accepting new patients
Hospitalist Medical Services, PSC CurrentSince Aug 18, 2024 Accepting new patients
Cook County CurrentSince Jul 1, 2023 Accepting new patients
Cook County Interventional Pain Medicine Current Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

Organizations & group practices 5

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": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1124531819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 CALLE BAYONA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009204039",
            "telephone_number": "787-547-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 AVE. DE DIEGO",
            "address_2": "SUITE 300, EDIF. SAN JUAN HEALTH CENTRE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009073714",
            "telephone_number": "787-729-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ NOGUERAS",
        "first_name": "EMMANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-16",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "PR",
            "license": "22699",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PR",
            "license": "22699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.