Individual provider Active NPI

Alexis Oquendo

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1205453842
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23493 Issued in PR
Practice address
Carr. 167 KM 7.1 Bo. Pajaros
Bayamon, PR 00956
Phone
(787) 464-6854
NPI assigned
Jun 30, 2020
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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 23493 PR Primary

Addresses

Primary practice location

Carr. 167 KM 7.1 Bo. Pajaros
Bayamon, PR 00956

Mailing address

RR 4 Box 26343
Toa Alta, PR 00953-9416
Phone (787) 464-6854

Other practice location 1

13260 N 13th St
Phoenix, AZ 85022-4936
Phone (787) 464-6854

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
I20231101003529 PR Practitioner - General Practice 9032565643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
San Juan Bautista School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Integral En la Montana IncGroup PAC ID 8527972827, 64 clinicians

Practice addresses (Care Compare)

Carr 167 KM
8 Bo Pajaros Puertorriquenos
Bayamon, PR 00961
Phone (787) 780-3435

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23493PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Salud Integral En la Montana, Inc Current Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Oct 1, 2023 Accepting new patients

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": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1205453842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 4 BOX 26343",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009539416",
            "telephone_number": "787-464-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 167 KM 7.1 BO. PAJAROS",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-464-6854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13260 N 13th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850224936",
            "country_code": "US",
            "telephone_number": "787-464-6854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OQUENDO",
        "first_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.