Advanceprimarycare Medicinepsc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

17154 Issued in PR

Legal business name

ADVANCEPRIMARYCARE MEDICINEPSC

Practice address

Barrio Guatemala
Carretera 111 KM 16.9
San Sebastian, PR 00685-7565

Phone

(787) 428-2299

NPI assigned

Nov 7, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jorge Ivan Mendez, MDNPI 1912169632

Title

President

Phone

(939) 969-2479

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.

• Jorge I Mendez, MD

  • General Practice Physician
  • San Sebastian, PR
  • NPI 1912169632

  PR

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1306190707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BARRIO JUNCAL CARRETERA 111 KM 30.3 SECTOR PUJOLS",
            "address_2": "HC03 BOX 35468",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006857565",
            "telephone_number": "939-969-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BARRIO GUATEMALA",
            "address_2": "CARRETERA 111 KM 16.9",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006857565",
            "telephone_number": "787-428-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCEPRIMARYCARE MEDICINEPSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "IVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "939-969-2479",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PR",
            "license": "17154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Advanced Wound Care Inc
• Hector Aguilar, MD
• Lynette Joan Albaladejo-Torres, MS
• Angel E Aleman Rivera, PH.D.
• Ivonne Aleman, PSY.D
• Janice Marie Almodovar Crespo, MD

• All providers in San Sebastian, PR
• Primary Care Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.