Individual provider Active NPI

Ivette Chiclana, M.D.

  • Specialist
  • Toa Baja, PR
National Provider Identifier
1285847244
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
SS 8 Plaza 9
Urb. Mansion del Sur
Toa Baja, PR 00949-4819
Phone
(787) 795-2485
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

SS 8 Plaza 9
Urb. Mansion del Sur
Toa Baja, PR 00949-4819

Mailing address

SS 8 Plaza 9
Urb. Mansion del Sur
Toa Baja, PR 00949-4819
Phone (787) 795-2485

Other identifiers 1

IdentifierTypeStateIssuer
5560OtherPRSTATE MEDICAL LICENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220221001832 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8426442237

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5560PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285847244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SS 8 PLAZA 9",
            "address_2": "URB. MANSION DEL SUR",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009494819",
            "telephone_number": "787-795-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SS 8 PLAZA 9",
            "address_2": "URB. MANSION DEL SUR",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009494819",
            "telephone_number": "787-795-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICLANA",
        "first_name": "IVETTE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENCE",
            "identifier": "5560",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Baja, PR

Sources for this page

Verify at the official NPI Registry.