Individual provider Active NPI

Norma Ursa Alonso, M.D.

  • Dermatology Physician
  • San Juan, PR
National Provider Identifier
1235136466
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
12164 Issued in PR
Practice address
Ave. Ponce de Leon 735
Torre Auxilio Mutuo Suite 519
San Juan, PR 00917
Phone
(787) 759-5122
Fax
(787) 753-4797
NPI assigned
Jul 1, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 12164 PR Primary

Addresses

Primary practice location

Ave. Ponce de Leon 735
Torre Auxilio Mutuo Suite 519
San Juan, PR 00917

Mailing address

Ave. Ponce de Leon 735
Torre Auxilio Mutuo Suite 519
San Juan, PR 00917
Phone (787) 759-5122

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
I20120821000730 PR Practitioner - Dermatology 5395992689 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12164PRMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Derma Medical Professional Corporation CurrentSince Oct 1, 2011 Accepting new patients

Locations

735 Ave Ponce de Leon
Ste 519
San Juan, PR 00917
Phone (787) 759-5122

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1235136466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVE. PONCE DE LEON 735",
            "address_2": "TORRE AUXILIO MUTUO SUITE 519",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-759-5122",
            "fax_number": "787-753-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. PONCE DE LEON 735",
            "address_2": "TORRE AUXILIO MUTUO SUITE 519",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-759-5122",
            "fax_number": "787-753-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALONSO",
        "first_name": "NORMA",
        "middle_name": "URSA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PR",
            "license": "12164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.