Individual provider Active NPI

Lydia I Ruiz Muniz, MD

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1356380455
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9612 Issued in PR
Practice address
Carolina Shopp Ctr
Primer Nivel Suite 7
Carolina, PR 00985-5672
Phone
(787) 768-0120
Fax
(787) 768-0120
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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 9612 PR Primary

Addresses

Primary practice location

Carolina Shopp Ctr
Primer Nivel Suite 7
Carolina, PR 00985-5672

Mailing address

Urb. Villa Antillana
An-32 Plaza San Vicente
Trujillo Alto, PR 00976
Phone (787) 646-1394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080424000087 PR Practitioner - General Practice 0446338925 Practice locations: Carolina, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carolina Shopping Court
Primer Nivel Oficina 7
Carolina, PR 00983-0001
Phone (787) 768-0120

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9612PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1356380455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. VILLA ANTILLANA",
            "address_2": "AN-32 PLAZA SAN VICENTE",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-646-1394",
            "fax_number": "787-768-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAROLINA SHOPP CTR",
            "address_2": "PRIMER NIVEL SUITE 7",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855672",
            "telephone_number": "787-768-0120",
            "fax_number": "787-768-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ MUNIZ",
        "first_name": "LYDIA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.