Individual provider Active NPI

Tatiana M Morell Colberg, M.D.

  • General Practice Physician
  • Hatillo, PR
National Provider Identifier
1215257605
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17829 Issued in PR
Practice address
Carr 490 KM 4.5
Hatillo, PR 00659-2628
Phone
(787) 566-3804
NPI assigned
Jun 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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 17829 PR Primary

Addresses

Primary practice location

Carr 490 KM 4.5
Hatillo, PR 00659-2628

Mailing address

PO Box 575
Camuy, PR 00627-0575

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
I20111014000069 PR Practitioner - General Practice 7911179098 Reassigns benefits to 1 organization
Practice locations: Camuy, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carr 129 KM
Hatillo, PR 00659
Phone (787) 898-0905

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17829PRMDGeneral Practice Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1215257605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 575",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "006270575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 490 KM 4.5",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006592628",
            "telephone_number": "787-566-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELL COLBERG",
        "first_name": "TATIANA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatillo, PR

Sources for this page

Verify at the official NPI Registry.