Individual provider Active NPI

Alexandra M Canabal Montalvo

  • General Practice Physician
  • Guaynabo, PR
National Provider Identifier
1265913396
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22501 Issued in PR
Practice address
D-4 Reina Victoria
Quintas Reales
Guaynabo, PR 00969
Phone
(787) 459-0097
NPI assigned
Aug 27, 2018
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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 22501 PR Primary

Addresses

Primary practice location

D-4 Reina Victoria
Quintas Reales
Guaynabo, PR 00969

Mailing address

Ave Casa Linda 1 Suite 101
Centro Preventivo Guaynabo
Bayamon, PR 00959-8998
Phone (787) 789-1996

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
I20211111001779 PR Practitioner - General Practice 6103215249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
San Juan Bautista School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Ave Casa Linda
Bayamon, PR 00959-9000
Phone (787) 789-1996

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22501PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Las Americas Guaynabo, Inc General Practice CurrentSince Nov 1, 2021 Accepting new patients
Clinica Las Americas Guaynabo, Inc Current Accepting new patients
Clinica Las Americas Guaynabo, Inc CurrentSince Nov 1, 2021 Accepting new patients

Locations

1 Ave Casa Linda
Bayamon, PR 00959

1 Ave Casa Linda
Ste 101
Bayamon, PR 00959
Phone (787) 399-9092

Interoperability endpoints

  • Direct secure messaging: alexandra.canabalmontalvo@4048.securemail.prognocis.com

Organizations & group practices 3

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": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1265913396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVE CASA LINDA 1 SUITE 101",
            "address_2": "CENTRO PREVENTIVO GUAYNABO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009598998",
            "telephone_number": "787-789-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "D-4 REINA VICTORIA",
            "address_2": "QUINTAS REALES",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-459-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANABAL MONTALVO",
        "first_name": "ALEXANDRA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.