Individual provider Active NPI

Waleska Pietri, MD

  • Family Medicine Physician
  • Ponce, PR
National Provider Identifier
1356467559
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10588 Issued in PR
Practice address
119 Callejon Patio Rosa
Bo. Pampanos
Ponce, PR 00717-0346
Phone
(787) 642-0964
Fax
(787) 840-2317
NPI assigned
Mar 21, 2007
Last updated
Apr 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10588 PR Primary

Addresses

Primary practice location

119 Callejon Patio Rosa
Bo. Pampanos
Ponce, PR 00717-0346

Mailing address

119 Callejon Patio Rosa
Bo. Pampanos
Ponce, PR 00717-0346
Phone (787) 642-0964

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
I20071002000249 PR Practitioner - Family Practice 4587759881 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10588PRMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tiber Health, Public Benefit Corporation Family Medicine CurrentSince Jul 1, 2015 Accepting new patients
Tiber Health, Public Benefit Corporation CurrentSince Jul 1, 2015 Accepting new patients
Ponce Medical School Foundation Inc Past Accepting new patients
Arist Medical Sciences University, Public Benefit Corporation Past Accepting new patients

Organizations & group practices 4

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1356467559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 CALLEJON PATIO ROSA",
            "address_2": "BO. PAMPANOS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170346",
            "telephone_number": "787-642-0964",
            "fax_number": "787-840-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CALLEJON PATIO ROSA",
            "address_2": "BO. PAMPANOS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170346",
            "telephone_number": "787-642-0964",
            "fax_number": "787-840-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRI",
        "first_name": "WALESKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "10588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.