Individual provider Active NPI

Lizbette Justiniano, M. D.

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1205032471
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16257 Issued in PR
Practice address
2213 Ponce Byp
Ponce, PR 00717-1318
Phone
(787) 840-8686
NPI assigned
Jun 25, 2007
Last updated
Dec 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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 16257 PR Primary

Addresses

Primary practice location

2213 Ponce Byp
Ponce, PR 00717-1318

Mailing address

3367 Calle Galaxia
Stalight
Ponce, PR 00717-1473
Phone (787) 316-8846

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
I20141007001235 PR Practitioner - General Practice 4183844566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Centro IncGroup PAC ID 5890692131, 62 clinicians

Practice addresses (Care Compare)

1034 Ave Hostos
Ponce, PR 00716-1115
Phone 78784393931025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16257PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Behavioral Care Corp. Current Accepting new patients
Med Centro, Inc. General Practice Current Accepting new patients
Inspira Behavioral Care Corp CurrentSince Aug 20, 2014 Accepting new patients
Med Centro, Inc. CurrentSince Dec 6, 2023 Accepting new patients
Inspira Behavioral Care Corp. CurrentSince Aug 20, 2014 Accepting new patients
Med Centro, Inc. CurrentSince Dec 6, 2023 Accepting new patients

Locations

1034 Ave Hostos
Ponce, PR 00716
Phone (787) 242-2279

55 Calle Comercio
Yauco, PR 00698
Phone (787) 267-1810

Interoperability endpoints

  • Direct secure messaging: lizbette.justiniano@medcentro.directbygreenway.com

Organizations & group practices 6

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1205032471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3367 CALLE GALAXIA",
            "address_2": "STALIGHT",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171473",
            "telephone_number": "787-316-8846",
            "fax_number": "787-984-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 PONCE BYP",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171318",
            "telephone_number": "787-840-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTINIANO",
        "first_name": "LIZBETTE",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.