Organization Active NPI

Gem CM M PSC

  • General Practice Physician
  • Aguadilla, PR
National Provider Identifier
1134834229
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
GEM CM M PSC
Practice address
Aguadilla Shopping Center #50
Carr 459 Ste #25 Y 30
Aguadilla, PR 00603
Phone
(787) 398-6856
NPI assigned
Jan 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Dr. Emanuel Moreno Candelaria
Title
MD
Phone
(787) 398-6856

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

Aguadilla Shopping Center #50
Carr 459 Ste #25 Y 30
Aguadilla, PR 00603

Mailing address

PO Box 4372
Aguadilla, PR 00605-4372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230330002788 PR Part B Supplier - Clinic/Group Practice 0941675144 Receives reassigned benefits from 1 practitioner
Practice locations: Aguadilla, PR

National Provider Directory

National Provider Directory

Locations

50 Carr 459
Ste 25
Aguadilla, PR 00603
Phone (787) 398-6856

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1134834229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4372",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006054372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AGUADILLA SHOPPING CENTER #50",
            "address_2": "CARR 459 STE #25 Y 30",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-398-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEM CM M PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-10",
        "status": "A",
        "authorized_official_last_name": "MORENO CANDELARIA",
        "authorized_official_first_name": "EMANUEL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "787-398-6856",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguadilla, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.