Individual provider Active NPI

Rafael Jose Albandoz Jr., MD

  • Gynecology Physician
  • San Juan, PR
National Provider Identifier
1316938194
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
6414 Issued in PR
Practice address
110 Calle Georgetti
San Juan, PR 00925-3505
Phone
(787) 764-1830
Fax
(787) 767-7741
NPI assigned
Nov 2, 2005
Sex
Male
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
Gynecology Physician 207VG0400X 6414 PR Primary

Addresses

Primary practice location

110 Calle Georgetti
San Juan, PR 00925-3505

Mailing address

26 Calle 1
Villa Los Olmos
San Juan, PR 00927-4605
Phone (787) 764-6267

Other identifiers 10

IdentifierTypeStateIssuer
068094OtherCRUZ AXUL
2849OtherAMERICAN HEALTH
26414OtherCIGNA
2992OtherIMC
PC0542OtherPALIC
2 7818OtherSSS
26414OtherMCS
9280027OtherHUMANA
3706414OtherUIA
209071OtherUTI

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

State licenses

LicenseStateTypeSpecialty
6414PRMDGynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1316938194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CALLE 1",
            "address_2": "VILLA LOS OLMOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009274605",
            "telephone_number": "787-764-6267",
            "fax_number": "787-764-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CALLE GEORGETTI",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009253505",
            "telephone_number": "787-764-1830",
            "fax_number": "787-767-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBANDOZ",
        "first_name": "RAFAEL",
        "middle_name": "JOSE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "PR",
            "license": "6414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AXUL",
            "identifier": "068094",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HEALTH",
            "identifier": "2849",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "26414",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMC",
            "identifier": "2992",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALIC",
            "identifier": "PC0542",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "2 7818",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCS",
            "identifier": "26414",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "9280027",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UIA",
            "identifier": "3706414",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTI",
            "identifier": "209071",
            "state": null
        }
    ],
    "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 Oct 1, 2012; 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.