Individual provider Active NPI

Alice M Encarnacion Collazo, M.D.

  • Pediatrics Physician
  • San Juan, PR
National Provider Identifier
1306880927
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
8446 Issued in PR
Practice address
349 Avenida Felisa Rincon de Gautier
Suite 202
San Juan, PR 00926-6675
Phone
(787) 999-0889
Fax
(787) 999-0891
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 8446 PR Primary

Addresses

Primary practice location

349 Avenida Felisa Rincon de Gautier
Suite 202
San Juan, PR 00926-6675

Mailing address

702 Calle Roosevelt
Suite 202
San Juan, PR 00907-3449
Phone (787) 484-6943

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
I20240213003665 PR Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8022452416

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8446PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Pediatrico Paseos Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alice.encarnacion@hpmpr.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1306880927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 CALLE ROOSEVELT",
            "address_2": "SUITE 202",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009073449",
            "telephone_number": "787-484-6943",
            "fax_number": "787-724-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 AVENIDA FELISA RINCON DE GAUTIER",
            "address_2": "SUITE 202",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266675",
            "telephone_number": "787-999-0889",
            "fax_number": "787-999-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENCARNACION COLLAZO",
        "first_name": "ALICE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "8446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.