Individual provider Active NPI

Ada Y. Miranda-Ruiz, M.D.

  • Family Medicine Physician
  • Arecibo, PR
National Provider Identifier
1154357234
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12561 Issued in PR
Practice address
Ave. Miramar #450
Arecibo, PR 00612
Phone
(787) 680-2190
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12561 PR Primary

Addresses

Primary practice location

Ave. Miramar #450
Arecibo, PR 00612

Mailing address

PO Box 1511
Quebradillas, PR 00678-1511
Phone (787) 380-5051

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060213000468 PR Practitioner - Family Practice 0244245249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Avenida Dr Susoni
Suite 121
Hatillo, PR 00659
Phone 7878984190406

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Corporacion Servicios Medicos Primarios Y Prevencion de Hatillo Family Medicine CurrentSince Feb 11, 2024 Accepting new patients
Corporacion de Servicios Medicos Primarios Y Prevencion de Hatillo Past Accepting new patients
Iliana Ruiz Past Accepting new patients
Corporacion de Servicios Medicos Primarios Y Prevencion de Hatillo Past Accepting new patients

Locations

121 Ave Dr Susoni
Hatillo, PR 00659
Phone (787) 314-5291

Organizations & group practices 4

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1154357234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1511",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006781511",
            "telephone_number": "787-380-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. MIRAMAR #450",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-680-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA-RUIZ",
        "first_name": "ADA",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "12561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.