Individual provider Active NPI

Awilda M Maldonado-Mercado, MD

  • Hematology & Oncology Physician
  • San Juan, PR
National Provider Identifier
1316930431
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
7692 Issued in PR
Practice address
10 Calle Casia
San Juan, PR 00921-3200
Phone
(787) 641-7582
Fax
(787) 641-4568
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 7692 PR Primary

Addresses

Primary practice location

10 Calle Casia
San Juan, PR 00921-3200

Mailing address

10 Calle Casia
San Juan, PR 00921-3200
Phone (787) 641-7582

Other identifiers 2

IdentifierTypeStateIssuer
1516OtherPRVA STAFF NUMBER
7692OtherPRSTATE LICENCE

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1316930431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CALLE CASIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213200",
            "telephone_number": "787-641-7582",
            "fax_number": "787-641-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CALLE CASIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213200",
            "telephone_number": "787-641-7582",
            "fax_number": "787-641-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO-MERCADO",
        "first_name": "AWILDA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PR",
            "license": "7692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA STAFF NUMBER",
            "identifier": "1516",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "7692",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.