NPIMap

Individual provider Active NPI

Julio Elvin Estrada Serrano, MD

  • General Practice Physician
  • Yabucoa, PR
National Provider Identifier
1306454566
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
021883 Issued in PR
Practice address
10 Calle Cristobal Colon
Yabucoa, PR 00767-3332
Phone
(787) 893-8204
NPI assigned
Jul 14, 2020
Last updated
Aug 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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 021883 PR Primary

Addresses

Primary practice location

10 Calle Cristobal Colon
Yabucoa, PR 00767-3332

Mailing address

HC 2 Box 7236
Las Piedras, PR 00771-9788
Phone (787) 326-2060

Other practice location 1

Carr 917 KM 10.1
Las Piedras, PR 00771
Phone (787) 326-2060

Other identifiers 1

IdentifierTypeStateIssuer
021883OtherPRPUERTO RICO MEDICAL DISCIPLINE AND LICENSURE BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200924000272 PR Practitioner - General Practice 1254750235 Reassigns benefits to 6 organizations
Practice locations: Yabucoa, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Integral En la Montana IncGroup PAC ID 8527972827, shared by 11 NPIs, 64 clinicians

Practice addresses (Care Compare)

18 Calle Gerardo Nieves Mercado
Comerio, PR 00782-2539
Phone (787) 875-3375

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021883PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc General Practice Current Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc. Current Accepting new patients
Salud Integral En la Montana, Inc General Practice Current Accepting new patients
Salud Integral En la Montana, Inc Current Accepting new patients
Salud Integral En la Montana, Inc. General Practice Current Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 17, 2021 Accepting new patients
E & R Med Consulting Services General Practice CurrentSince May 7, 2023 Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 17, 2021 Accepting new patients

Locations

156 Calle Barcelo
#53
Barranquitas, PR 00794
Phone (787) 857-2688

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1306454566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 2 BOX 7236",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007719788",
            "telephone_number": "787-326-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CALLE CRISTOBAL COLON",
            "city": "YABUCOA",
            "state": "PR",
            "postal_code": "007673332",
            "telephone_number": "787-893-8204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Carr 917 KM 10.1",
            "address_purpose": "LOCATION",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "00771",
            "country_code": "US",
            "telephone_number": "787-326-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTRADA SERRANO",
        "first_name": "JULIO",
        "middle_name": "ELVIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "021883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUERTO RICO MEDICAL DISCIPLINE AND LICENSURE BOARD",
            "identifier": "021883",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yabucoa, PR

Sources for this page

Verify at the official NPI Registry.