Individual provider Active NPI

Carmen I. Altiery Ruiz, M.D.

  • General Practice Physician
  • Isabela, PR
National Provider Identifier
1174766166
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17500 Issued in PR
Practice address
Carr. 4494 KM 1.2 Int Calle la Cumbre # 360
Bo Arenales
Isabela, PR 00662
Phone
(787) 609-6468
Fax
(787) 609-3017
NPI assigned
Apr 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2024

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 17500 PR Primary

Addresses

Primary practice location

Carr. 4494 KM 1.2 Int Calle la Cumbre # 360
Bo Arenales
Isabela, PR 00662

Mailing address

6830 Carr 4484
Quebradillas, PR 00678-2750
Phone (787) 609-6468

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
I20100609000641 PR Practitioner - General Practice 9234269705 Practice locations: Isabela, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17500PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1174766166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6830 CARR 4484",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006782750",
            "telephone_number": "787-609-6468",
            "fax_number": "787-609-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 4494 KM 1.2 INT CALLE LA CUMBRE # 360",
            "address_2": "BO ARENALES",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "00662",
            "telephone_number": "787-609-6468",
            "fax_number": "787-609-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTIERY RUIZ",
        "first_name": "CARMEN",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-07",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Isabela, PR

Sources for this page

Verify at the official NPI Registry.