Individual provider Active NPI

Jose Raul Ayala-Cuervos Sr., MD

  • Internal Medicine Physician
  • Bayamon, PR
National Provider Identifier
1245294925
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4355 Issued in PR
Practice address
303 Bayamon
Bayamon Medical Plaza
Bayamon, PR 00960
Phone
(787) 786-4627
Fax
(787) 780-6680
NPI assigned
Apr 12, 2006
Last updated
Mar 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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 4355 PR Primary

Addresses

Primary practice location

303 Bayamon
Bayamon Medical Plaza
Bayamon, PR 00960

Mailing address

PO Box 8389
Bayamon, PR 00960-8389
Phone (787) 786-4627

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
I20101117000997 PR Practitioner - Internal Medicine 4183819055 Practice locations: Bayamon, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4355PRMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1245294925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8389",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009608389",
            "telephone_number": "787-786-4627",
            "fax_number": "787-780-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 BAYAMON",
            "address_2": "BAYAMON MEDICAL PLAZA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00960",
            "telephone_number": "787-786-4627",
            "fax_number": "787-780-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYALA-CUERVOS",
        "first_name": "JOSE",
        "middle_name": "RAUL",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "4355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.