Individual provider Active NPI

Alfredo Julian Bou Prieto, MD

  • Dermatology Physician
  • Bayamon, PR
National Provider Identifier
1285049635
Registry record updated Sep 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
19872 Issued in PR
Practice address
J15 Ave Betances
Bayamon, PR 00959-5108
Phone
(787) 272-0855
NPI assigned
Jun 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 19872 PR Primary

Addresses

Primary practice location

J15 Ave Betances
Bayamon, PR 00959-5108

Mailing address

436 Calle Rey Luis
Guaynabo, PR 00969-3170
Phone (787) 233-0335

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
I20190402000878 PR Practitioner - Dermatology 9335480219 Reassigns benefits to 1 organization
Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Puerto Rico School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

J15 Ave Betances
Bayamon, PR 00959-5108
Phone (787) 223-7594

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions541
Removal or shaving of skin growth27
Skin biopsy366

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrate Community Health System CurrentSince Sep 21, 2018 Accepting new patients
Integrate Community Health System, Inc. CurrentSince Sep 21, 2018 Accepting new patients
Integrate Community Health System Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alfredo.bouprieto.p1@direct.vitacare.nextgenshare.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599868800000",
    "number": "1285049635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 CALLE REY LUIS",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009693170",
            "telephone_number": "787-233-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "J15 AVE BETANCES",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009595108",
            "telephone_number": "787-272-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOU PRIETO",
        "first_name": "ALFREDO",
        "middle_name": "JULIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2020-09-12",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PR",
            "license": "19872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.