Individual provider Active NPI

Mario Santaella Maldonado, MD

  • Internal Medicine Physician
  • Sabana Grande, PR
National Provider Identifier
1265417497
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9933 Issued in PR
Practice address
17 Calle Baldorioty
Sabana Grande, PR 00637
Phone
(787) 873-4345
NPI assigned
Dec 9, 2005
Last updated
Feb 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 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 9933 PR Primary

Addresses

Primary practice location

17 Calle Baldorioty
Sabana Grande, PR 00637

Mailing address

PO Box 1327
San German, PR 00683-1327
Phone (787) 873-4345

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
I20100505000820 PR Practitioner - Internal Medicine 3870621287 Reassigns benefits to 1 organization
Practice locations: Sabana Grande, PR; San German, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17 Calle Baldorioty
Sabana Grande, PR 00637-1822
Phone (787) 873-4345

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mario Santaella Medicina Interna CSP Internal Medicine CurrentSince Oct 6, 2012 Accepting new patients

Locations

8 Calle Javilla
San German, PR 00683
Phone (787) 892-2880

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1265417497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1327",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006831327",
            "telephone_number": "787-873-4345",
            "fax_number": "787-873-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CALLE BALDORIOTY",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "00637",
            "telephone_number": "787-873-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTAELLA MALDONADO",
        "first_name": "MARIO",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "9933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sabana Grande, PR

Sources for this page

Verify at the official NPI Registry.