Individual provider Active NPI

Carlos Manuel Declet Larrinaga, MD

  • Medical Physician Assistant
  • Adjuntas, PR
National Provider Identifier
1336831965
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1669-P.A. Issued in PR
Practice address
20 Calle Rius Rivera
Adjuntas, PR 00601-2337
Phone
(787) 702-3500
NPI assigned
May 23, 2023
Last updated
May 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1669-P.A. PR Primary

Addresses

Primary practice location

20 Calle Rius Rivera
Adjuntas, PR 00601-2337

Mailing address

20 Calle Rius Rivera
Adjuntas, PR 00601-2337
Phone (787) 702-3500

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1669-P.A.PRMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1336831965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CALLE RIUS RIVERA",
            "city": "ADJUNTAS",
            "state": "PR",
            "postal_code": "006012337",
            "telephone_number": "787-702-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CALLE RIUS RIVERA",
            "city": "ADJUNTAS",
            "state": "PR",
            "postal_code": "006012337",
            "telephone_number": "787-702-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECLET LARRINAGA",
        "first_name": "CARLOS",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "1669-P.A.",
            "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 May 23, 2023; 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.