Primary Medical Group,C.S.P.
Organization Active NPI Family Medicine Physician · Ponce, PR
NPI 1174593545 · NPPES record last updated Jan 4, 2010
Key facts
- NPI
- 1174593545
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 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
- Organization subpart
- No
Authorized official
- Name
- Iraida Del Rio, M.D.
- Title
- Presidente
- Phone
- (787) 813-0080
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 3
Practitioners 21
-
Sergio Chevere Mourino, M.D.
-
Nilmaris Segarra, MD
-
Glyced Flores-Dejesus, M.D.
-
Moraima Pagan la Torre, M.D.
-
Danna M Perez Torruella, M.D.
-
Robert Rodriguez Perez, M.D.
-
Irma Seda, MD
-
Daniel Ortiz, MSW
-
Malynie D Blanco Burgos, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Primary Medical Group CSP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Geriatric Medicine (Family Medicine) Physician |
207QG0300X | |||
| Internal Medicine Physician |
207R00000X | |||
| Pediatrics Physician |
208000000X | |||
| General Practice Physician |
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
Other providers in Ponce, PR
- Primary Medical Center, Inc
- Primary Medical Group San Cristobal
- Primary Medical Group Santa Marta
- Primary Medical Group, C.S.P.
- Primary Medical Group,C.S.P.
- Priority Emergency Response Corp
- Priority Medical Management LLC
- Pro-Care Medical Equipment, Inc.
- Professional Ambulance
- Professional Integrated Medical Solution,PSC
All providers in Ponce, PR · Family Medicine Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.