San Juan Internal Medicine LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SAN JUAN INTERNAL MEDICINE LLC

Practice address

29 Calle Washington Ste 309
San Juan, PR 00907-1509

Phone

(787) 396-6336

NPI assigned

Oct 20, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Marcus Santiago Hernandez, MD

Title

President

Phone

(633) 678-7396

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marcos Santiago Hernandez, MD

  • Specialist
  • San Juan, PR
  • NPI 1619080389
  Medicare reassignment

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1295498889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8069",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009100069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 CALLE WASHINGTON STE 309",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071509",
            "telephone_number": "787-396-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "SANTIAGO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "633-678-7396",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Juan City Hospital
• San Juan City Hospital
• San Juan Dental Center LLC
• San Juan Endodontics PSC
• San Juan Healthcare-Homeless
• San Juan Medical Assoc PSC
• San Juan Medical Imaging
• San Juan Medical Laboratory
• San Juan Medical Pharmacy
• San Juan Nephrology P.S.C.

• Specialist in San Juan, PR
• Providers in San Juan, PR by specialty
• Specialist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.