Individual provider Active NPI

Maricarmen Cardona-Bosque, M.D.

  • General Practice Physician
  • Mayaguez, PR
National Provider Identifier
1275915829
Registry record updated Feb 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19647 Issued in PR
Practice address
61 Calle Mendez Vigo E
Mayaguez, PR 00680-5569
Phone
(787) 834-2558
NPI assigned
Jun 19, 2015
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

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
I20191127000073 PR Practitioner - General Practice 7113350414 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19647PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Costa Salud Community Health Centers, Inc CurrentSince Nov 1, 2019 Accepting new patients
Costa Salud Community Health Centers, Inc. CurrentSince Nov 1, 2019 Accepting new patients

Locations

124 Calle Calazan Lasalle
Moca, PR 00676
Phone (787) 815-5500

28 Calle Munoz Rivera W
Rincon, PR 00677
Phone (787) 823-5500

Interoperability endpoints

  • Direct secure messaging: maricarmen.cardona@costasalud.directbygreenway.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 19647 PR Primary

Addresses

NPPES NPI Registry

Primary practice location

61 Calle Mendez Vigo E
Mayaguez, PR 00680-5569

Mailing address

PO Box 1463
Mayaguez, PR 00681-1463

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 4, 2024.

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707004800000",
    "number": "1275915829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1463",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006811463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 CALLE MENDEZ VIGO E",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006805569",
            "telephone_number": "787-834-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA-BOSQUE",
        "first_name": "MARICARMEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2024-02-04",
        "certification_date": "2024-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.