Individual provider Active NPI

Sandra C. Gracia-Lopez, M.D.

  • Nuclear Medicine Physician
  • Aibonito, PR
National Provider Identifier
1184680480
Registry record updated Aug 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
License
7213 Issued in PR
Practice address
Ave. Jose Vazquez Esq. Dr. Troyer
Nuclear Medicine, Mennonite General Hospital
Aibonito, PR 00705-1379
Phone
(787) 735-8001
Fax
(787) 292-7976
NPI assigned
Apr 25, 2006
Last updated
Aug 2, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7213 PR
Nuclear Medicine Physician 207U00000X 7213 PR Primary

Addresses

Primary practice location

Ave. Jose Vazquez Esq. Dr. Troyer
Nuclear Medicine, Mennonite General Hospital
Aibonito, PR 00705-1379

Mailing address

Urb. Paseo de la Fuente
D-4 Calle Tivoli
San Juan, PR 00926-6459
Phone (787) 641-7582

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
I20081024000080 PR Practitioner - Nuclear MedicinePractitioner - Internal Medicine 8123186806 Practice locations: Aibonito, PR; Cayey, PR; Caguas, PR

Care Compare profile

Medicare Care Compare
Specialty
Nuclear MedicineAlso: Internal Medicine
Education
Ponce School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

KM72 Carr
Suite 14
Cayey, PR 00736
Phone (787) 738-2195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7213PRMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186012800000",
    "number": "1184680480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. PASEO DE LA FUENTE",
            "address_2": "D-4 CALLE TIVOLI",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266459",
            "telephone_number": "787-641-7582",
            "fax_number": "787-292-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. JOSE VAZQUEZ ESQ. DR. TROYER",
            "address_2": "NUCLEAR MEDICINE, MENNONITE GENERAL HOSPITAL",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "007051379",
            "telephone_number": "787-735-8001",
            "fax_number": "787-292-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACIA-LOPEZ",
        "first_name": "SANDRA",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "7213",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "PR",
            "license": "7213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aibonito, PR

Sources for this page

Verify at the official NPI Registry.