Organization Active NPI

Upgrade Spine LLC

  • Chiropractor
  • San Juan, PR
National Provider Identifier
1336945765
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
UPGRADE SPINE LLC
Practice address
First Federal Building, Suite 607
Ponce de Leon Ave 1519
San Juan, PR 00908
Phone
(787) 702-5200
NPI assigned
Feb 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Authorized official

Name
Jorge O Colon Balaguer, DCNPI 1134878010
Title
Owner
Phone
(787) 604-4343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

First Federal Building, Suite 607
Ponce de Leon Ave 1519
San Juan, PR 00908

Mailing address

First Federal Building, Suite 607
Ponce de Leon Ave 1519
San Juan, PR 00908
Phone (787) 702-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250404003387 PR Part B Supplier - Clinic/Group Practice 0648794115 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

1519 Ave Ponce de Leon
Ste 607
San Juan, PR 00909
Phone (787) 702-5200

1 Ave Ponce de Leon
Ste 607
San Juan, PR 00917
Phone (787) 702-5200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1336945765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FIRST FEDERAL BUILDING, SUITE 607",
            "address_2": "PONCE DE LEON AVE 1519",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00908",
            "telephone_number": "787-702-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FIRST FEDERAL BUILDING, SUITE 607",
            "address_2": "PONCE DE LEON AVE 1519",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00908",
            "telephone_number": "787-702-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPGRADE SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "COLON BALAGUER",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-604-4343",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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, 2025; 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.