Individual provider Active NPI

Yaina Sierra Cordova, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1275225211
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23932 Issued in PR
Practice address
715 Ave Ponce de Leon
San Juan, PR 00917-5032
Phone
(787) 758-2000
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 23932 PR Primary

Addresses

Primary practice location

715 Ave Ponce de Leon
San Juan, PR 00917-5032

Mailing address

Cond. Los Pinos
Apt 605
Caguas, PR 00725
Phone (787) 955-0976

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
I20240927002385 PR Practitioner - General Practice 4486185766 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23932PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc. Single Specialty CurrentSince Sep 1, 2024 Accepting new patients
Salud Integral En la Montana, Inc Single Specialty CurrentSince Sep 1, 2024 Accepting new patients
Salud Integral En la Montana, Inc. Single Specialty CurrentSince Sep 1, 2024 Accepting new patients
Salud Integral En la Montana, Inc. Single Specialty CurrentSince Sep 1, 2024 Accepting new patients

Locations

156 Calle Barcelo
#53
Barranquitas, PR 00794
Phone (787) 857-2688

23 Calle Jose de Diego
Toa Alta, PR 00953
Phone (787) 870-0008

Organizations & group practices 4

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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1275225211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND. LOS PINOS",
            "address_2": "APT 605",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-955-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 AVE PONCE DE LEON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175032",
            "telephone_number": "787-758-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA CORDOVA",
        "first_name": "YAINA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "23932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.