NPIMap

Organization Active NPI

Ayala Preventive Medicine PSC

  • Primary Care Clinic/Center
  • Mayaguez, PR
National Provider Identifier
1255636437
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
6806 Issued in PR
Legal business name
AYALA PREVENTIVE MEDICINE PSC
Practice address
167 Calle Ramos Antonini E
Mayaguez, PR 00680-5039
Phone
(787) 833-5235
Fax
(787) 831-1790
NPI assigned
Jan 19, 2011
Last updated
Jul 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Authorized official

Name
Dr. Marcos A Ayala Rivera, MDNPI 1194772640
Title
President
Phone
(787) 833-5235

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 6806 PR Primary

Addresses

Primary practice location

167 Calle Ramos Antonini E
Mayaguez, PR 00680-5039

Mailing address

PO Box 1568
Mayaguez, PR 00681-1568
Phone (787) 833-5235

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110909002738 PR Part B Supplier - Clinic/Group Practice 8527238112 Receives reassigned benefits from 1 practitioner
Practice locations: Mayaguez, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311897600000",
    "number": "1255636437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1568",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006811568",
            "telephone_number": "787-833-5235",
            "fax_number": "787-831-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 CALLE RAMOS ANTONINI E",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006805039",
            "telephone_number": "787-833-5235",
            "fax_number": "787-831-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AYALA PREVENTIVE MEDICINE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-19",
        "last_updated": "2011-07-29",
        "status": "A",
        "authorized_official_last_name": "AYALA RIVERA",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-833-5235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PR",
            "license": "6806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.