Individual provider Active NPI

Fernando Ortiz Maldonado, M.D.

  • Internal Medicine Physician
  • Juncos, PR
National Provider Identifier
1255387445
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5647 Issued in PR
Practice address
Calle Celis Aguilera Num 6
Esq Daniel Flores
Juncos, PR 00777-0000
Phone
(787) 734-0181
Fax
(787) 734-0181
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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 5647 PR Primary

Addresses

Primary practice location

Calle Celis Aguilera Num 6
Esq Daniel Flores
Juncos, PR 00777-0000

Mailing address

PO Box 1725
Juncos, PR 00777-1725
Phone (787) 734-0181

Other identifiers 6

IdentifierTypeStateIssuer
27264OtherPRTRIPLE S
065643OtherPRCRUZ AZUL DE PUERTO RICO
6660014OtherPRHUMANA HEALTH PLAN
0508OtherPRFIRST MEDICAL
3902OtherPRPREFERRED MEDICARE CHOICE
6660014OtherPRHUMANA INSURANCE

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
I20120413000496 PR Practitioner - Internal Medicine 6305007642 Practice locations: Juncos, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 Calle Celis Aguilera
Juncos, PR 00777-3228
Phone (787) 734-0181

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1255387445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1725",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007771725",
            "telephone_number": "787-734-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE CELIS AGUILERA NUM 6",
            "address_2": "ESQ DANIEL FLORES",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007770000",
            "telephone_number": "787-734-0181",
            "fax_number": "787-734-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ MALDONADO",
        "first_name": "FERNANDO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "5647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "27264",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL DE PUERTO RICO",
            "identifier": "065643",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA HEALTH PLAN",
            "identifier": "6660014",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST MEDICAL",
            "identifier": "0508",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED MEDICARE CHOICE",
            "identifier": "3902",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA INSURANCE",
            "identifier": "6660014",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Juncos, PR

Sources for this page

Verify at the official NPI Registry.