Individual provider Active NPI

Joanic Ydaligisa Santos - Pimentel, M.D.

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1245480268
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
18587 Issued in PR
Practice address
33-16 Calle 11
Carolina, PR 00985-5449
Phone
(787) 633-1385
NPI assigned
Sep 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME125554 FL
General Practice Physician 208D00000X 18587 PR Primary

Addresses

Primary practice location

33-16 Calle 11
Carolina, PR 00985-5449

Mailing address

PO Box 4143
Carolina, PR 00984-4143
Phone (787) 633-1385

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
I20200520000002 PR Practitioner - General Practice 2163640863 Practice locations: Carolina, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME125554FLMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1245480268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4143",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009844143",
            "telephone_number": "787-633-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33-16 CALLE 11",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855449",
            "telephone_number": "787-633-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS - PIMENTEL",
        "first_name": "JOANIC",
        "middle_name": "YDALIGISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME125554",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.