Active NPI
Graciela Santos Mendez
- Student in an Organized Health Care Education/Training Program
- Ponce, PR
National Provider Identifier
1316609449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 2212
- Practice address
- A18 Calle Palma Real
Villas de Sagrado Corazon
Ponce, PR 00716 - Phone
- (787) 408-8257
- NPI assigned
- Oct 6, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 36013 | FL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 2212 | PR | Primary |
Addresses
Primary practice location
A18 Calle Palma Real
Villas de Sagrado Corazon
Ponce, PR 00716
Mailing address
A18 Calle Palma Real
Villas de Sagrado Corazon
Ponce, PR 00716
Phone (787) 408-8257
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2212 | Other | PR | INTERN CERTIFICATE |
| 36013 | Other | FL | INTERN CERTIFICATE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36013 | FL | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633478400000",
"number": "1316609449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "A18 CALLE PALMA REAL",
"address_2": "VILLAS DE SAGRADO CORAZON",
"city": "PONCE",
"state": "PR",
"postal_code": "00716",
"telephone_number": "787-408-8257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "A18 CALLE PALMA REAL",
"address_2": "VILLAS DE SAGRADO CORAZON",
"city": "PONCE",
"state": "PR",
"postal_code": "00716",
"telephone_number": "787-408-8257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTOS MENDEZ",
"first_name": "GRACIELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-06",
"last_updated": "2021-10-06",
"certification_date": "2021-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "36013",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PR",
"license": "2212",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERN CERTIFICATE",
"identifier": "2212",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERN CERTIFICATE",
"identifier": "36013",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.