Organization Active NPI

Zom Professional Gastroenterology, PSC

  • Gastroenterology Physician
  • San Juan, PR
National Provider Identifier
1144530916
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
15,931 Issued in PR
Legal business name
ZOM PROFESSIONAL GASTROENTEROLOGY, PSC
Practice address
Calle Turquesa, #28
Senderos de Montehiedra
San Juan, PR 00926
Phone
(787) 963-0550
Fax
(787) 963-0550
NPI assigned
Oct 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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

Authorized official

Name
Dr. Zhamarie Ortiz Mercado, MDNPI 1841391927
Title
Medico
Phone
(787) 318-6197

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 15,931 PR Primary

Addresses

Primary practice location

Calle Turquesa, #28
Senderos de Montehiedra
San Juan, PR 00926

Mailing address

PO Box 364584
San Juan, PR 00936-4584
Phone (787) 318-6197

Other identifiers 1

IdentifierTypeStateIssuer
15,931OtherPRLICENCIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101108000044 PR Part B Supplier - Clinic/Group Practice 0446445290 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1144530916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 364584",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009364584",
            "telephone_number": "787-318-6197",
            "fax_number": "787-963-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE TURQUESA, #28",
            "address_2": "SENDEROS DE MONTEHIEDRA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-963-0550",
            "fax_number": "787-963-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZOM PROFESSIONAL GASTROENTEROLOGY, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "ORTIZ MERCADO",
        "authorized_official_first_name": "ZHAMARIE",
        "authorized_official_title_or_position": "MEDICO",
        "authorized_official_telephone_number": "787-318-6197",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "15,931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA",
            "identifier": "15,931",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; 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.