Individual provider Active NPI

Ivonne Maestre-Garcia, M.D.

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1295843118
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
11887 Issued in PR
Practice address
Ave. Monserrate Aa 3
Valle Arriba Heights
Carolina, PR 00984
Phone
(787) 776-2050
Fax
(787) 776-2050
NPI assigned
Aug 29, 2006
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
General Practice Physician 208D00000X 11887 PR Primary

Addresses

Primary practice location

Ave. Monserrate Aa 3
Valle Arriba Heights
Carolina, PR 00984

Mailing address

397 Calle Petunia
Ciudad Jardin
Carolina, PR 00987-2242
Phone (787) 776-2050

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
I20140402000274 PR Practitioner - General Practice 2365673555 Practice locations: Fajardo, PR; Carolina, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11887PRMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295843118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 CALLE PETUNIA",
            "address_2": "CIUDAD JARDIN",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009872242",
            "telephone_number": "787-776-2050",
            "fax_number": "787-776-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. MONSERRATE AA 3",
            "address_2": "VALLE ARRIBA HEIGHTS",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00984",
            "telephone_number": "787-776-2050",
            "fax_number": "787-776-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAESTRE-GARCIA",
        "first_name": "IVONNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "11887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.