Individual provider Active NPI

Alejandro Mayobanex Marmolejo, M.D.

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1306940481
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
10598 Issued in PR
Practice address
J1 5 Street Urb Hillside
San Juan, PR 00926-5225
Phone
(787) 720-4043
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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 10598 PR Primary

Addresses

Primary practice location

J1 5 Street Urb Hillside
San Juan, PR 00926-5225

Mailing address

J1 Calle 5 Urb Hillside
San Juan, PR 00926-5225
Phone (787) 720-4043

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
I20031211000875 PR Practitioner - General PracticePractitioner - Emergency Medicine 9133025877 Reassigns benefits to 1 organization
Practice locations: Cayey, PR

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Emergency Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gobierno Municipal de CayeyGroup PAC ID 8628073533, 4 clinicians

Practice addresses (Care Compare)

174 Calle Luis Barreras S
Cayey, PR 00736-4615
Phone (787) 738-3011

Hospital & facility affiliations

  • Hospital Menonita de Cayey Hospital, Cayey, PR, CCN 400013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gobierno Municipal de Cayey CurrentSince Apr 1, 2018 Accepting new patients
Gobierno Municipal de Cayey CurrentSince Apr 1, 2018 Accepting new patients
Hospital Menonita de Cayey General Practice Past Accepting new patients
Hospital Menonita de Cayey Past Accepting new patients

Locations

174 Calle Luis Barreras S
Cayey, PR 00736
Phone (787) 263-0966

Organizations & group practices 4

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1306940481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "J1 CALLE 5 URB HILLSIDE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265225",
            "telephone_number": "787-720-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "J1 5 STREET URB HILLSIDE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265225",
            "telephone_number": "787-720-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMOLEJO",
        "first_name": "ALEJANDRO",
        "middle_name": "MAYOBANEX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "10598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.