NPIMap

Organization Active NPI

Primary Medical Group,C.S.P.

  • Family Medicine Physician
  • Ponce, PR
National Provider Identifier
1174593545
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMARY MEDICAL GROUP,C.S.P.
Practice address
Calle Ferrocarril
# 607
Ponce, PR 00717-1195
Phone
(787) 813-0257
Fax
(787) 840-8874
NPI assigned
Jan 26, 2006
Last updated
Jan 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Authorized official

Name
Iraida Del Rio, M.D.
Title
Presidente
Phone
(787) 813-0080

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

Calle Ferrocarril
# 607
Ponce, PR 00717-1195

Mailing address

PO Box 336149
Ponce, PR 00733-6149
Phone (787) 813-0257

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040626000264 PR Part B Supplier - Clinic/Group Practice 4385556083 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
Practice locations: Jayuya, PR; Ponce, PR; San Juan, PR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Primary Medical Groupcsp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262563200000",
    "number": "1174593545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 336149",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007336149",
            "telephone_number": "787-813-0257",
            "fax_number": "787-840-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE FERROCARRIL",
            "address_2": "# 607",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171195",
            "telephone_number": "787-813-0257",
            "fax_number": "787-840-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY MEDICAL GROUP,C.S.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2010-01-04",
        "status": "A",
        "authorized_official_last_name": "DEL RIO",
        "authorized_official_first_name": "IRAIDA",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-813-0080",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.