Individual provider Active NPI

Edgardo Morales Serrano, DPM

  • Podiatrist
  • San Juan, PR
National Provider Identifier
1275594244
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
099 Issued in PR
Practice address
400 Ave Domenech
Las Americas Professional Center Suite 306
San Juan, PR 00918-3710
Phone
(787) 975-8192
Fax
(787) 975-8193
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 099 PR Primary

Addresses

Primary practice location

400 Ave Domenech
Las Americas Professional Center Suite 306
San Juan, PR 00918-3710

Mailing address

PO Box 2582
Guaynabo, PR 00970-2582
Phone (787) 975-8192

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040921000113 PR Practitioner - Podiatry 6901874676 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Ave Domenech
San Juan, PR 00918-3710
Phone (787) 975-8192

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue221
Removal of skin lesions1-10
Removal of nail tissue1536
Removal or shaving of skin growth43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1275594244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2582",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009702582",
            "telephone_number": "787-975-8192",
            "fax_number": "787-975-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AVE DOMENECH",
            "address_2": "LAS AMERICAS PROFESSIONAL CENTER SUITE 306",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183710",
            "telephone_number": "787-975-8192",
            "fax_number": "787-975-8193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES SERRANO",
        "first_name": "EDGARDO",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PR",
            "license": "099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.