Luis Antonio Bracero Baumgartner, MD

Individual provider Active NPI Physician Assistant · Ponce, PR

NPI 1144147653 · NPPES record last updated Jul 4, 2026

Key facts

NPI
1144147653
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
2359 (PR)
Practice address
1955 Calle Fortuna
Ponce, PR 00717-2304
Phone
(787) 439-8717
NPI assigned
Jul 4, 2026
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
363A00000X 2359 PR Yes

Addresses

Primary practice location

1955 Calle Fortuna
Ponce, PR 00717-2304

Mailing address

1955 Calle Fortuna
Ponce, PR 00717-2304

Other providers in Ponce, PR

All providers in Ponce, PR · Physician Assistant in Puerto Rico

Sources for this page

Verify at the official NPI Registry.