Individual provider Active NPI

David A Carballeira, MD

  • Internal Medicine Physician
  • Caguas, PR
National Provider Identifier
1174524748
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8472 Issued in PR
Practice address
Q36 Ave Munoz Marin
Caguas, PR 00725-6158
Phone
(787) 743-5848
Fax
(787) 743-8855
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8472 PR Primary

Addresses

Primary practice location

Q36 Ave Munoz Marin
Caguas, PR 00725-6158

Mailing address

PO Box 194327
San Juan, PR 00919-4327
Phone (787) 743-5848

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
I20060628000295 PR Practitioner - Internal MedicinePractitioner - Geriatric Medicine 6800808239 Practice locations: Caguas, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
University of Puerto Rico School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Ave Muoz Marin
Q36 Urb Villa Carmen
Caguas, PR 00725-0001
Phone (787) 743-5848

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8472PRMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1174524748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 194327",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009194327",
            "telephone_number": "787-743-5848",
            "fax_number": "787-743-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "Q36 AVE MUNOZ MARIN",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007256158",
            "telephone_number": "787-743-5848",
            "fax_number": "787-743-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBALLEIRA",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "8472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.