Individual provider Active NPI

Aili L Plaza, MEDICAL TECHNOLOGIST

  • Clinical Medical Laboratory
  • Adjuntas, PR
National Provider Identifier
1326106782
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
396 Issued in PR
Practice address
Rius Rivera #9
Adjuntas, PR 00601
Phone
(787) 829-4004
Fax
(787) 829-2008
NPI assigned
Dec 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 396 PR Primary

Addresses

Primary practice location

Rius Rivera #9
Adjuntas, PR 00601

Mailing address

PO Box 1130
Rius Rivera #9
Adjuntas, PR 00601
Phone (787) 829-4004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080624000715 PR Part B Supplier - Independent Clinical Laboratory 0143391847 Practice locations: Adjuntas, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
396PRMDNutrition Chiropractor

Locations

9 Calle Rius Rivera
Adjuntas, PR 00601
Phone (787) 829-4004

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326106782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1130",
            "address_2": "RIUS RIVERA #9",
            "city": "ADJUNTAS",
            "state": "PR",
            "postal_code": "00601",
            "telephone_number": "787-829-4004",
            "fax_number": "787-829-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RIUS RIVERA #9",
            "city": "ADJUNTAS",
            "state": "PR",
            "postal_code": "00601",
            "telephone_number": "787-829-4004",
            "fax_number": "787-829-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAZA",
        "first_name": "AILI",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MEDICAL TECHNOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adjuntas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.