Individual provider Active NPI

Juan A Tosado Polanco, MD

  • Obstetrics Physician
  • Guayama, PR
National Provider Identifier
1285715326
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
13906 Issued in PR
Practice address
Urb la Hacienda Avenida Albizu Campos
Hospital Menonita Suite 209
Guayama, PR 00784
Phone
(787) 866-5010
Fax
(787) 866-5010
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 13906 PR Primary

Addresses

Primary practice location

Urb la Hacienda Avenida Albizu Campos
Hospital Menonita Suite 209
Guayama, PR 00784

Mailing address

15408 Calle Flamboyan
Urb. Paseos de Jacaranda
Santa Isabel, PR 00757-9621
Phone (787) 559-7119

Other practice location 1

15408 Calle Flamboyan
Urb. Paseos de Jacaranda
Santa Isabel, PR 00757-9621
Phone (787) 559-7119

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
I20070928000285 PR Practitioner - Obstetrics/Gynecology 3577658095 Reassigns benefits to 1 organization
Practice locations: Guayama, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13906PRMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Servicios Primarios de Salud de Patillas Inc.-Maunabo CurrentSince Feb 1, 2020 Accepting new patients
Centro de Servicios Primarios de Salud de Patillas Inc. CurrentSince Feb 1, 2020 Accepting new patients
Centro Servicios Primarios de Salud de Patillas Inc. Current Accepting new patients
Hospital Menonita Guayama Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: juan.tosado@cspsp.directbygreenway.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1285715326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15408 CALLE FLAMBOYAN",
            "address_2": "URB. PASEOS DE JACARANDA",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "007579621",
            "telephone_number": "787-559-7119",
            "fax_number": "787-845-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB LA HACIENDA AVENIDA ALBIZU CAMPOS",
            "address_2": "HOSPITAL MENONITA SUITE 209",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-866-5010",
            "fax_number": "787-866-5010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15408 Calle Flamboyan",
            "address_2": "Urb. Paseos de Jacaranda",
            "address_purpose": "LOCATION",
            "city": "Santa Isabel",
            "state": "PR",
            "postal_code": "007579621",
            "country_code": "US",
            "telephone_number": "787-559-7119",
            "fax_number": "787-845-6958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOSADO POLANCO",
        "first_name": "JUAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "PR",
            "license": "13906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guayama, PR

Sources for this page

Verify at the official NPI Registry.