Alberto Ivan Almodovar, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

003319 Issued in PR

Practice address

51 Calle de Diego E
Mayaguez, PR 00680-5497

Phone

(787) 833-3548

Fax

(787) 265-7788

NPI assigned

Apr 11, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

DentistAlso: Periodontics

Education

University of Puerto Rico School of Dentistry, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Periodoncia del Oeste LLC

  • Periodontics
  • Mayaguez, PR
  • NPI 1912701376
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134583693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2896",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006812896",
            "telephone_number": "787-833-3548",
            "fax_number": "787-265-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 CALLE DE DIEGO E",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006805497",
            "telephone_number": "787-833-3548",
            "fax_number": "787-265-7788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Essex St",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "MA",
            "postal_code": "018414396",
            "country_code": "US",
            "telephone_number": "978-683-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALMODOVAR",
        "first_name": "ALBERTO",
        "middle_name": "IVAN",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2022-07-21",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857504",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "PR",
            "license": "003319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivan Raul Alicea, PSICOLOGO
• All Medical Supply Inc
• Diana L Allende, M.D.
• Robert Miguel Almanzar Nunez, MD
• Gustavo Jesus Almodovar-Mercado, M.D.
• Angel Roberto Almodovar, MD
• Juan Carlos Almodovar, M.D.
• Hecmanuel Alonso Gil
• Hector M Alonso Sr.
• Brunilda Annette Altieri Mercado

• All providers in Mayaguez, PR
• Periodontics in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.