Individual provider Active NPI

Jose Luis Mercado Santiago, MD

  • General Practice Physician
  • Isabela, PR
National Provider Identifier
1306010699
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17119 Issued in PR
Practice address
Carr. #2 K.M 106.4
Isabela, PR 00662
Phone
(787) 484-1793
NPI assigned
Apr 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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 17119 PR Primary

Addresses

Primary practice location

Carr. #2 K.M 106.4
Isabela, PR 00662

Mailing address

PO Box 2479
Isabela, PR 00662-9479
Phone (787) 484-1793

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
I20081202000326 PR Practitioner - General Practice 0244391803 Reassigns benefits to 1 organization
Practice locations: Isabela, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21 Calle Juan Gonzalez
Isabela, PR 00662-2812
Phone (787) 609-6391

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Mercado Benero PSC General Practice CurrentSince Apr 20, 2021 Accepting new patients
Policlinica del Atlantico Corp Past Accepting new patients

Organizations & group practices 2

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": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1306010699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2479",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006629479",
            "telephone_number": "787-484-1793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. #2 K.M 106.4",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "00662",
            "telephone_number": "787-484-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO SANTIAGO",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-17",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Isabela, PR

Sources for this page

Verify at the official NPI Registry.