Individual provider Active NPI

Pedro C Roman Eyxarch, MD

  • Internal Medicine Physician
  • Bayamon, PR
National Provider Identifier
1306903422
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11804 Issued in PR
Practice address
Carimed Plaza
Suite 309 Calle Santa Cruz B1
Bayamon, PR 00961
Phone
(787) 740-4465
Fax
(787) 785-2680
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11804 PR Primary

Addresses

Primary practice location

Carimed Plaza
Suite 309 Calle Santa Cruz B1
Bayamon, PR 00961

Mailing address

PO Box 1617
Bayamon, PR 00959
Phone (787) 740-4465

Other identifiers 8

IdentifierTypeStateIssuer
060607OtherCRUZ AZUL
212102OtherPREFFERED HEALTH
89556OtherTRIPLE S
89556OtherTRIPLE S OPTIMO
1111981OtherACAA
2251OtherINTERNATIONAL MEDICAL CAR
89556OtherMEDICARE SELECTO
3106OtherPREFFERED MEDICARE CHOICE

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
I20081024000396 PR Practitioner - Internal Medicine 3476611187 Reassigns benefits to 1 organization
Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

B1 Calle Santa Cruz
Bayamon, PR 00961-6928
Phone (787) 740-4465

Hospital & facility affiliations

  • Hospital Espanol Auxilio Mutuo San Pablo Hospital, Bayamon, PR, CCN 400109

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperativa de Facultad Medica Sanacoop CurrentSince May 4, 2016 Accepting new patients

Locations

B7 Calle Santa Cruz
Bayamon, PR 00961
Phone (787) 780-9191

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1306903422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1617",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-740-4465",
            "fax_number": "787-785-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARIMED PLAZA",
            "address_2": "SUITE 309 CALLE SANTA CRUZ B1",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-740-4465",
            "fax_number": "787-785-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN EYXARCH",
        "first_name": "PEDRO",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "11804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "060607",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFFERED HEALTH",
            "identifier": "212102",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "89556",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S OPTIMO",
            "identifier": "89556",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACAA",
            "identifier": "1111981",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONAL MEDICAL CAR",
            "identifier": "2251",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SELECTO",
            "identifier": "89556",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFFERED MEDICARE CHOICE",
            "identifier": "3106",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.