Individual provider Active NPI

Samara Baez-Quinones

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1174684153
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15532 Issued in PR
Practice address
1715 Ave Ponce de Leon
Ste S1
San Juan, PR 00909-1966
Phone
(787) 458-6177
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 15532 PR Primary

Addresses

Primary practice location

1715 Ave Ponce de Leon
Ste S1
San Juan, PR 00909-1966

Mailing address

Cond Jardines de Montehiedra 1500
Apto 801
San Juan, PR 00926
Phone (787) 458-6177

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
I20060210000352 PR Practitioner - General Practice 9032124144 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15532PRMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Menr Medical Services Corp. General Practice CurrentSince Mar 21, 2012 Accepting new patients
Municipality of Catano Past Accepting new patients

Locations

1866 Ave Ponce de Leon
San Juan, PR 00909
Phone (787) 268-4433

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1174684153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND JARDINES DE MONTEHIEDRA 1500",
            "address_2": "APTO 801",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-458-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 AVE PONCE DE LEON",
            "address_2": "STE S1",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009091966",
            "telephone_number": "787-458-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ-QUINONES",
        "first_name": "SAMARA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.