NPIMap

Organization Active NPI

Premium Medical Group PSC

  • General Practice Physician
  • Arecibo, PR
National Provider Identifier
1205548815
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PREMIUM MEDICAL GROUP PSC
Practice address
Carretera 129, KM 1.0 Av. San Luis
Arecibo, PR 00613
Phone
(787) 650-7272
NPI assigned
Dec 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Dr. Edgardo Martin Vargas, MD
Title
Doctor of Medicine
Phone
(787) 639-4908

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

Carretera 129, KM 1.0 Av. San Luis
Arecibo, PR 00613

Mailing address

Carretera 129, KM 1.0 Av. San Luis
Arecibo, PR 00613
Phone (787) 650-7272

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1205548815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CARRETERA 129, KM 1.0 AV. SAN LUIS",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00613",
            "telephone_number": "787-650-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 129, KM 1.0 AV. SAN LUIS",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00613",
            "telephone_number": "787-650-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM MEDICAL GROUP PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "EDGARDO",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "DOCTOR OF MEDICINE",
        "authorized_official_telephone_number": "787-639-4908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.