Individual provider Active NPI

Juan Andres Arango Morales, MD

  • Student in an Organized Health Care Education/Training Program
  • Bridgeport, CT
National Provider Identifier
1174296677
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
267 Grant Street
Med Ed Podium 4
Bridgeport, CT 06610-0120
Phone
(646) 421-8072
NPI assigned
Jul 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CT Primary

Addresses

Primary practice location

267 Grant Street
Med Ed Podium 4
Bridgeport, CT 06610-0120

Mailing address

267 Grant Street
Med Ed Podium 4
Bridgeport, CT 06610-0120
Phone (646) 421-8072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210907002458 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4880090463

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jarango659086@direct.ynhh.org

NPI Registry JSON

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1174296677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 GRANT STREET",
            "address_2": "MED ED PODIUM 4",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066100120",
            "telephone_number": "646-421-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT STREET",
            "address_2": "MED ED PODIUM 4",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066100120",
            "telephone_number": "646-421-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARANGO MORALES",
        "first_name": "JUAN",
        "middle_name": "ANDRES",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-29",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.