Organization Active NPI

Gastro Med del Sur, P.S.C.

  • Specialist
  • Ponce, PR
National Provider Identifier
1245231497
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
8042 Issued in PR
Legal business name
GASTRO MED DEL SUR, P.S.C.
Practice address
909 Ave. Tito Castro Suite 518
Torre Medica San Lucas
Ponce, PR 00716-4721
Phone
(787) 290-2948
Fax
(787) 841-4832
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Authorized official

Name
Mrs. Carmen L. Santiago, M.D.
Title
President
Phone
(787) 290-2948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 8042 PR Primary

Addresses

Primary practice location

909 Ave. Tito Castro Suite 518
Torre Medica San Lucas
Ponce, PR 00716-4721

Mailing address

909 Ave. Tito Castro Suite 518
Torre Medica San Lucas
Ponce, PR 00716-4721
Phone (787) 290-2948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080701000538 PR Part B Supplier - Clinic/Group Practice 3274605563 Receives reassigned benefits from 1 practitioner
Practice locations: Ponce, PR

National Provider Directory

National Provider Directory

Locations

909 Ave Tito Castro
Ste 518
Ponce, PR 00716
Phone (787) 290-2948

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1245231497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 AVE. TITO CASTRO SUITE 518",
            "address_2": "TORRE MEDICA SAN LUCAS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164721",
            "telephone_number": "787-290-2948",
            "fax_number": "787-841-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 AVE. TITO CASTRO SUITE 518",
            "address_2": "TORRE MEDICA SAN LUCAS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164721",
            "telephone_number": "787-290-2948",
            "fax_number": "787-841-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTRO MED DEL SUR, P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-290-2948",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "8042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.