Individual provider Active NPI

Francisco R Carballo Duran, M.D.

  • Internal Medicine Physician
  • Humacao, PR
National Provider Identifier
1174591093
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8260 Issued in PR
Practice address
13 Calle Flor Gerena N
Humacao, PR 00791-4288
Phone
(787) 518-0104
NPI assigned
Mar 8, 2006
Last updated
Dec 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 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 8260 PR Primary

Addresses

Primary practice location

13 Calle Flor Gerena N
Humacao, PR 00791-4288

Mailing address

185 Candelero Dr Apt 608
Fairlakes Village
Humacao, PR 00791-6133
Phone (787) 518-0104

Other identifiers 5

IdentifierTypeStateIssuer
9110030OtherPRHUMANA
212353OtherPRPREFERRED HEALTH
80952-CAOtherPRTRIPLE S
P070OtherPRFIRST MEDICAL
11-1015-2OtherPRACAA

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
I20050625000000 PR Practitioner - Internal Medicine 6709821143 Reassigns benefits to 1 organization
Practice locations: Caguas, PR; Fajardo, PR; Humacao, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Calle Flor Gerena 13 Norte
Humacao, PR 00791-4288
Phone (787) 518-0104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8260PRMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc CurrentSince Jul 6, 2015 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Jul 6, 2015 Accepting new patients
Im Precision Medical Group PSC Internal Medicine Past Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

404 Ave General Valero
Fajardo, PR 00738
Phone (781) 299-4731

3 Calle Font Martelo E
Humacao, PR 00791
Phone (787) 656-2427

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1174591093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 CANDELERO DR APT 608",
            "address_2": "FAIRLAKES VILLAGE",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007916133",
            "telephone_number": "787-518-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 CALLE FLOR GERENA N",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914288",
            "telephone_number": "787-518-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBALLO DURAN",
        "first_name": "FRANCISCO",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "8260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "9110030",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH",
            "identifier": "212353",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "80952-CA",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST MEDICAL",
            "identifier": "P070",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACAA",
            "identifier": "11-1015-2",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.