Individual provider Active NPI

Luis Marrero Abascal, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1326209073
Registry record updated Aug 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
018662 Issued in PR
Practice address
RR 36 Box 1239
San Juan, PR 00926-9805
Phone
(787) 923-9625
NPI assigned
Jun 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2014

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 018662 PR Primary

Addresses

Primary practice location

RR 36 Box 1239
San Juan, PR 00926-9805

Mailing address

RR 36 Box 1239
San Juan, PR 00926-9805
Phone (787) 923-9625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140819000603 PR Practitioner - General Practice 2769609510 Practice locations: Guaynabo, PR
I20180821001144 FL Practitioner - General Practice 2769609510 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Doctors Intrastate LLCGroup PAC ID 5395161186, 74 clinicians

Practice addresses (Care Compare)

729 Beville Rd
South Daytona, FL 32119-1823
Phone (386) 256-4791

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018662PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roy H Hinman MD PA CurrentSince Mar 10, 2018 Accepting new patients
Island Doctors Intrastate LLC CurrentSince Feb 5, 2021 Accepting new patients

Locations

1737 N Clyde Morris Blvd
Daytona Beach, FL 32117
Phone (321) 888-3020

1737 N Clyde Morris Blvd
Ste 150
Daytona Beach, FL 32117
Phone (386) 256-2370

700 Sterthaus Dr
Ormond Beach, FL 32174
Phone (386) 301-4067

729 Beville Rd
South Daytona, FL 32119
Phone (386) 256-4791

103 Anastasia Blvd
St Augustine, FL 32080
Phone (904) 825-4747

2460 Old Moultrie Rd
Ste 2
St Augustine, FL 32086
Phone (904) 293-0299

100 Arricola Ave
St Augustine, FL 32080
Phone (904) 825-4368

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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 2

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1326209073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 36 BOX 1239",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009269805",
            "telephone_number": "787-923-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 36 BOX 1239",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009269805",
            "telephone_number": "787-923-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO ABASCAL",
        "first_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "018662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.