Individual provider Active NPI

Anibal Moreno, M.D

  • General Practice Physician
  • Coamo, PR
National Provider Identifier
1235169764
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9162 Issued in PR
Practice address
18 Calle Mario Braschi
Coamo, PR 00769-2526
Phone
(787) 825-1020
Fax
(787) 825-1043
NPI assigned
Jul 3, 2006
Last updated
Jun 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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 9162 PR Primary

Addresses

Primary practice location

18 Calle Mario Braschi
Coamo, PR 00769-2526

Mailing address

18 Calle Mario Braschi
Coamo, PR 00769-2526
Phone (787) 825-1020

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
I20080909000690 PR Practitioner - General Practice 7315013737 Practice locations: Coamo, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 Calle Mario Braschi
Coamo, PR 00769-2515
Phone (787) 825-1020

National Provider Directory

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

Organizations & group practices 2

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1235169764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CALLE MARIO BRASCHI",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "007692526",
            "telephone_number": "787-825-1020",
            "fax_number": "787-825-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CALLE MARIO BRASCHI",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "007692526",
            "telephone_number": "787-825-1020",
            "fax_number": "787-825-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "ANIBAL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coamo, PR

Sources for this page

Verify at the official NPI Registry.