Karen M Canellas Correa, M.D.
Individual provider Active NPI General Practice Physician · Gurabo, PR
NPI 1235201773 · NPPES record last updated Mar 21, 2024
Key facts
- NPI
- 1235201773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 16245 (PR)
- Practice address
- 168 Calle Cundiamor
Ciudad Jardin Gurabo
Gurabo, PR 00778-9720 - Phone
- (787) 627-7781
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120911000691 | PR | Practitioner - General Practice |
7012165327 |
Reassigns benefits to 3 organizations Practice locations: Juncos, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Domiciliary Care Organization of Puerto Rico | General Practice | Current |
Accepting new patients |
| Doctor House, Inc | Current |
Accepting new patients |
Locations
49 Calle Munoz Rivera
Juncos, PR 00777
Phone (787) 561-0107
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 16245 | PR | Yes |
| Family Medicine Physician | 207Q00000X | 16245 | PR |
Addresses
Primary practice location
168 Calle Cundiamor
Ciudad Jardin Gurabo
Gurabo, PR 00778-9720
Mailing address
168 Calle Cundiamor
Ciudad Jardin de Gurabo
Gurabo, PR 00778-9720
Phone (787) 627-7781
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16245 | Other | PR | MEDICAL LICENSE |
Other providers in Gurabo, PR
- Luz Minerba Cabezudo
- Ninoshka Caceres Carrion
- Ricardo M Calderon Ortiz
- Ishell Y. Calzada
- Gabriel Andres Cancio Gonzalez
- Yeyca Canuelas
- America Caraballo
- Carasima Inc
- Cardio View and Vascular Center CSP
- Mariangeli Cardona
All providers in Gurabo, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.