Individual provider Active NPI

Idalia Evelyn Borrero, M.D.

  • General Practice Physician
  • Arecibo, PR
National Provider Identifier
1215022892
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
7513 Issued in PR
Practice address
Carr #2 KM 63.1
Bo Candelaria
Arecibo, PR 00612
Phone
(787) 881-4228
Fax
(787) 650-7802
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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 7513 PR Primary

Addresses

Primary practice location

Carr #2 KM 63.1
Bo Candelaria
Arecibo, PR 00612

Mailing address

PO Box 641
Sabana Hoyos, PR 00688
Phone (787) 881-4228

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
I20110516000046 PR Practitioner - General Practice 4880870518 Practice locations: Arecibo, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7513PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1215022892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641",
            "city": "SABANA HOYOS",
            "state": "PR",
            "postal_code": "00688",
            "telephone_number": "787-881-4228",
            "fax_number": "787-881-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #2 KM 63.1",
            "address_2": "BO CANDELARIA",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-881-4228",
            "fax_number": "787-650-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORRERO",
        "first_name": "IDALIA",
        "middle_name": "EVELYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "7513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.