Individual provider Active NPI

Nydia Ivette Burgos Ortega

  • Endocrinology, Diabetes & Metabolism Physician
  • Guaynabo, PR
National Provider Identifier
1215313986
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
19944 Issued in PR
Practice address
101 Ave San Patricio Ste 1070
Guaynabo, PR 00968-3048
Phone
(787) 221-7540
NPI assigned
Aug 5, 2015
Last updated
Apr 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 019944 PR
Student in an Organized Health Care Education/Training Program 390200000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X 19944 PR Primary

Addresses

Primary practice location

101 Ave San Patricio Ste 1070
Guaynabo, PR 00968-3048

Mailing address

PO Box 192082
San Juan, PR 00919-2082
Phone (787) 221-7540

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
I20220915000008 PR Practitioner - EndocrinologyPractitioner - Internal Medicine 8628453438 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
University of Puerto Rico School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Integral En la Montana IncGroup PAC ID 8527972827, shared by 11 NPIs, 64 clinicians

Practice addresses (Care Compare)

101 Ave San Patricio
Guaynabo, PR 00968-2645
Phone (787) 509-6877

12 2 Carr 152 KM
Naranjito, PR 00719

Carr 155 Ave Luis Munoz Marin
Orocovis, PR 00719
Phone (787) 867-6010

Carr 164 Sector El Desvio
Bo Achiote
Naranjito, PR 00719
Phone (787) 869-1290

PO Box
Naranjito, PR 00719

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019944PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc Single Specialty CurrentSince Sep 27, 2022 Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Sep 27, 2022 Accepting new patients
Salud Integral En la Montana, Inc Single Specialty Current Accepting new patients
Salud Integral En la Montana, Inc Single Specialty Current Accepting new patients
Salud Integral En la Montana, Inc. Single Specialty Current Accepting new patients
Salud Integral En la Montana, Inc Single Specialty CurrentSince Sep 27, 2022 Accepting new patients
Salud Integral En la Montana, Inc Single Specialty Current Accepting new patients
Salud Integral En la Montana, Inc Single Specialty CurrentSince Sep 27, 2022 Accepting new patients
Salud Integral En la Montana, Inc. Single Specialty Current Accepting new patients
Panacea Salud LLC Single Specialty CurrentSince Sep 2, 2022 Accepting new patients
Salud Integral En la Montana, Inc Single Specialty CurrentSince Sep 27, 2022 Accepting new patients
Salud Integral En la Montana, Inc. Single Specialty CurrentSince Sep 27, 2022 Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Sep 27, 2022 Accepting new patients

Locations

156 Calle Barcelo
#53
Barranquitas, PR 00794
Phone (787) 857-2688

101 Ave San Patricio
Ste 1070
Guaynabo, PR 00968
Phone (787) 221-7540

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1215313986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192082",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009192082",
            "telephone_number": "787-221-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AVE SAN PATRICIO STE 1070",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009683048",
            "telephone_number": "787-221-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS ORTEGA",
        "first_name": "NYDIA",
        "middle_name": "IVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "019944",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PR",
            "license": "19944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.