Individual provider Active NPI

Lourdes Marrero Diaz, M.D.

  • General Practice Physician
  • Trujillo Alto, PR
National Provider Identifier
1205800216
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16259 Issued in PR
Practice address
305 Calle Cruz
Trujillo Alto, PR 00976-5941
Phone
(787) 293-2700
Fax
(787) 998-3685
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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 16259 PR Primary

Addresses

Primary practice location

305 Calle Cruz
Trujillo Alto, PR 00976-5941

Mailing address

Re2 Via Piedras
Trujillo Alto, PR 00976-6016
Phone (787) 293-2700

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
I20060301000082 PR Practitioner - General Practice 8729094735 Reassigns benefits to 1 organization
Practice locations: Trujillo Alto, PR

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

Practice addresses (Care Compare)

715 Ave Ponce de Leon
San Juan, PR 00917-5032
Phone 78775820003470

735 Ave Ponce de Leon
Suite 375
San Juan, PR 00917-5025
Phone (787) 758-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
66.19
Improvement activities
40
Cost
73.97

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue360

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16259PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Jun 23, 2021 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Jun 23, 2021 Accepting new patients
Endomedicine LLC PastSince Jul 24, 2022 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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1205800216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RE2 VIA PIEDRAS",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009766016",
            "telephone_number": "787-293-2700",
            "fax_number": "787-998-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 CALLE CRUZ",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009765941",
            "telephone_number": "787-293-2700",
            "fax_number": "787-998-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO DIAZ",
        "first_name": "LOURDES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trujillo Alto, PR

Sources for this page

Verify at the official NPI Registry.