Individual provider Active NPI

Pedro Luis Nieves Garnica I, M.D.

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1225014061
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8116 Issued in PR
Practice address
334 Oficina 1 Ave. Americo Miranda
Urb Villa Nevarez
San Juan, PR 00927-4721
Phone
(787) 767-4853
Fax
(787) 767-4853
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8116 PR Primary

Addresses

Primary practice location

334 Oficina 1 Ave. Americo Miranda
Urb Villa Nevarez
San Juan, PR 00927-4721

Mailing address

Delcasse 20, Apt. 1103
San Juan, PR 00907-1698
Phone (787) 767-4853

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
I20060324000126 PR Practitioner - Internal Medicine 2365450830 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8116PRMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Therapy Center, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1225014061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DELCASSE 20, APT. 1103",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071698",
            "telephone_number": "787-767-4853",
            "fax_number": "787-767-4853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 OFICINA 1 AVE. AMERICO MIRANDA",
            "address_2": "URB VILLA NEVAREZ",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009274721",
            "telephone_number": "787-767-4853",
            "fax_number": "787-767-4853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES GARNICA",
        "first_name": "PEDRO",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "8116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.