Malave Surgical Group,PSC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

15768 Issued in PR

Legal business name

MALAVE SURGICAL GROUP,PSC

Practice address

Carretera Estatal #3 KM 78.4
Parcela 3 Bo. Rio Abajo
Humacao, PR 00791

Phone

(787) 600-4404

NPI assigned

Feb 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Victor Brian Malave, MDNPI 1548475791

Title

President

Phone

(787) 600-4404

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Tax ID family

Malave Surgical Group PSC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Malave Surgical Group, PSC

  • Surgery Physician
  • Las Piedras, PR
  • NPI 1871901728
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victor Brian Malave, M.D.

  • Surgery Physician
  • Aibonito, PR
  • NPI 1548475791
  Medicare reassignment Care Compare group NPD Authorized official
• Michelle Rivera Resto, M.D.

  • Gastroenterology Physician
  • Las Piedras, PR
  • NPI 1982812376
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1392595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401148800000",
    "number": "1164846879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MANSIONES DE LOS ARTESANOS #14",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "00771",
            "telephone_number": "787-600-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA ESTATAL #3 KM 78.4",
            "address_2": "PARCELA 3 BO. RIO ABAJO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-600-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALAVE SURGICAL GROUP,PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-17",
        "last_updated": "2014-05-27",
        "status": "A",
        "authorized_official_last_name": "MALAVE",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-600-4404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "15768",
            "primary": true
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hepatology",
            "state": "PR",
            "license": "15768",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "PR",
            "license": "16315",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0026258",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "EC729A",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Agripino Lugo Velazquez, MD
• Alexis Lugo-Mas
• Leslie Y Lugo
• Gordon R. Macdonald, M.D.
• Jose M Machicote, MD
• Daisy Del Carmen Malave, RDA
• Evelyn Maldonado Camis, PHD
• Iris Nereida Maldonado
• Jesus Alberto Maldonado, MD
• Lillian Maldonado, RPHA

• Gastroenterology Physician in Humacao, PR
• Providers in Humacao, PR by specialty
• Gastroenterology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.