Individual provider Active NPI

Ashlie Marie Maldonado Perez, MD

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1164087672
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22885 Issued in PR
Practice address
Phsu 388 Zona Industrial Reparada 2
Ponce, PR 00716
Phone
(787) 840-2575
NPI assigned
May 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 22885 PR Primary

Addresses

Primary practice location

Phsu 388 Zona Industrial Reparada 2
Ponce, PR 00716

Mailing address

St 33 Urb Jard de Caribe #FF34
Ponce, PR 00728
Phone (787) 342-5231

Other identifiers 1

IdentifierTypeStateIssuer
1322401-03OtherFIRST MEDICAL

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
I20230410001886 PR Practitioner - General Practice 0345615258 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22885PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1164087672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ST 33 URB JARD DE CARIBE #FF34",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00728",
            "telephone_number": "787-342-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PHSU 388 ZONA INDUSTRIAL REPARADA 2",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00716",
            "telephone_number": "787-840-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO PEREZ",
        "first_name": "ASHLIE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "22885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST MEDICAL",
            "identifier": "1322401-03",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.