Organization Active NPI

Advanced Gastroenterology, PSC

  • Gastroenterology Physician
  • Bayamon, PR
National Provider Identifier
1164720975
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
ADVANCED GASTROENTEROLOGY, PSC
Practice address
68 Calle Santa Cruz
Torre San Pablo Suite 803B
Bayamon, PR 00961-7031
Phone
(787) 288-6998
NPI assigned
Mar 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Authorized official

Name
Dr. Ramon M Rullan, MDNPI 1417930488
Title
President
Phone
(787) 288-6998

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X

Addresses

Primary practice location

68 Calle Santa Cruz
Torre San Pablo Suite 803B
Bayamon, PR 00961-7031

Mailing address

68 Calle Santa Cruz
Torre San Pablo Suite 803B
Bayamon, PR 00961-7031
Phone (787) 288-6998

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110610000284 PR Part B Supplier - Clinic/Group Practice 8527245943 Receives reassigned benefits from 2 practitioners
Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory

Locations

68 Calle Santa Cruz
Ste 703
Bayamon, PR 00961
Phone (787) 288-6998

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": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1164720975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 CALLE SANTA CRUZ",
            "address_2": "TORRE SAN PABLO SUITE 803B",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617031",
            "telephone_number": "787-288-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 CALLE SANTA CRUZ",
            "address_2": "TORRE SAN PABLO SUITE 803B",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617031",
            "telephone_number": "787-288-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GASTROENTEROLOGY, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "RULLAN",
        "authorized_official_first_name": "RAMON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-288-6998",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.