Individual provider Active NPI

Andre Jose Marquez, DC

  • Chiropractor
  • Guaynabo, PR
National Provider Identifier
1154684298
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009002 Issued in GA
Practice address
100 Carr. 165 Centro Internacional de Comercio
Suite 303
Guaynabo, PR 00968
Phone
(404) 917-7775
Fax
(787) 277-0847
NPI assigned
Jun 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009002 GA Primary
Chiropractor 111N00000X 518 PR

Addresses

Primary practice location

100 Carr. 165 Centro Internacional de Comercio
Suite 303
Guaynabo, PR 00968

Mailing address

100 Carr. 165 Centro Internacional de Comercio
Suite 303
Guaynabo, PR 00968
Phone (404) 917-7775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140211000355 PR Practitioner - Chiropractic 5799914974 Practice locations: Carolina, PR

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Uu48 Calle Pinto
Carolina, PR 00987-8126
Phone (787) 605-3188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009002GAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1154684298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CARR. 165 CENTRO INTERNACIONAL DE COMERCIO",
            "address_2": "SUITE 303",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00968",
            "telephone_number": "404-917-7775",
            "fax_number": "787-277-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CARR. 165 CENTRO INTERNACIONAL DE COMERCIO",
            "address_2": "SUITE 303",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00968",
            "telephone_number": "404-917-7775",
            "fax_number": "787-277-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "ANDRE",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009002",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.