Individual provider Active NPI

Ronald Delgado - Matos, MD

  • General Practice Physician
  • Canovanas, PR
National Provider Identifier
1265554174
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
009638 Issued in PR
Practice address
188 Calle 1
Bo San Isidro
Canovanas, PR 00729-2650
Phone
(787) 957-7733
Fax
(787) 957-7733
NPI assigned
Apr 4, 2007
Last updated
Dec 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 009638 PR Primary

Addresses

Primary practice location

188 Calle 1
Bo San Isidro
Canovanas, PR 00729-2650

Mailing address

NN35 Calle Yaurel
Mansiones de Carolina
Carolina, PR 00987-8119
Phone (787) 957-7733

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
I20071024000013 PR Practitioner - Family Practice 1658467527 Reassigns benefits to 1 organization
Practice locations: Canovanas, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009638PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Instituto Medico del Norte Inc CurrentSince Jul 27, 2015 Accepting new patients
Instituto Medico del Norte Inc CurrentSince Jul 27, 2015 Accepting new patients

Organizations & group practices 2

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1265554174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NN35 CALLE YAUREL",
            "address_2": "MANSIONES DE CAROLINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009878119",
            "telephone_number": "787-957-7733",
            "fax_number": "787-957-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 CALLE 1",
            "address_2": "BO SAN ISIDRO",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007292650",
            "telephone_number": "787-957-7733",
            "fax_number": "787-957-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO - MATOS",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "009638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canovanas, PR

Sources for this page

Verify at the official NPI Registry.