Individual provider Active NPI

Ernesto X Marrero de Gracia, M.D.

  • Internal Medicine Physician
  • Bayamon, PR
National Provider Identifier
1295743367
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15171 Issued in PR
Practice address
Instituto San Pablo
Suite 507 Calle Santa Cruz #66
Bayamon, PR 00961
Phone
(787) 740-2010
Fax
(787) 740-8377
NPI assigned
Aug 4, 2006
Sex
Male
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
Internal Medicine Physician 207R00000X 15171 PR Primary

Addresses

Primary practice location

Instituto San Pablo
Suite 507 Calle Santa Cruz #66
Bayamon, PR 00961

Mailing address

C/2 R-11
San Souci
Bayamon, PR 00957
Phone (787) 599-1174

Other names 1

  • Dr. Ernesto X Marrero de Gracia Former name

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
I20060908000298 PR Practitioner - Internal Medicine 0648274498 Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

66 Calle Santa Cruz
Bayamon, PR 00961-7041
Phone (787) 740-2011

Hospital & facility affiliations

  • Hospital Espanol Auxilio Mutuo San Pablo Hospital, Bayamon, PR, CCN 400109

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Am Acquisition I, LLC Past Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295743367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/2 R-11",
            "address_2": "SAN SOUCI",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00957",
            "telephone_number": "787-599-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INSTITUTO SAN PABLO",
            "address_2": "SUITE 507 CALLE SANTA CRUZ #66",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-740-2010",
            "fax_number": "787-740-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO DE GRACIA",
        "first_name": "ERNESTO",
        "middle_name": "X",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "15171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERNESTO",
            "last_name": "MARRERO DE GRACIA",
            "middle_name": "X",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.