Individual provider Active NPI

Dorian M Lopez-Bracetty, MD

  • Interventional Pain Medicine Physician
  • San Juan, PR
National Provider Identifier
1184848210
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
16661 Issued in PR
Practice address
311 Ave Domenech
San Juan, PR 00918-3511
Phone
(787) 758-2525
Fax
(787) 848-0318
NPI assigned
Apr 12, 2007
Last updated
Feb 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 16661 PR Primary
Anesthesiology Physician 207L00000X 16661 PR

Addresses

Primary practice location

311 Ave Domenech
San Juan, PR 00918-3511

Mailing address

35 Calle Juan C Borbon Ste 67-465
Guaynabo, PR 00969-5374
Phone (787) 525-0731

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
I20071106000650 PR Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 5193812261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
University of Puerto Rico School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

365 Ave Domenech
San Juan, PR 00918-3708
Phone (787) 675-0050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stop the Pain CSP Interventional Pain Medicine CurrentSince Jan 31, 2010 Accepting new patients
Recinto de Ciencias Medicas CurrentSince Dec 12, 2007 Accepting new patients
Recinto de Ciencias Medicas Anesthesiology CurrentSince Dec 12, 2007 Accepting new patients

Locations

35 Calle Juan C Borbon
Ste 67
Guaynabo, PR 00969
Phone (787) 287-0353

311 Ave Domenech
San Juan, PR 00918
Phone (787) 429-4369

365 Calle Manuel Domenech
San Juan, PR 00918
Phone (787) 675-0050

Centro Medico De Puerto Ri
San Juan, PR 00935

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1184848210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CALLE JUAN C BORBON STE 67-465",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009695374",
            "telephone_number": "787-525-0731",
            "fax_number": "787-848-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 AVE DOMENECH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183511",
            "telephone_number": "787-758-2525",
            "fax_number": "787-848-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-BRACETTY",
        "first_name": "DORIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "PR",
            "license": "16661",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PR",
            "license": "16661",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.