Individual provider Active NPI

Hector Moreno Fuentes

  • Internal Medicine Physician
  • Vega Baja, PR
National Provider Identifier
1356713176
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19497 Issued in PR
Practice address
431 Tulane
Vega Baja, PR 00693
Phone
(787) 382-4410
NPI assigned
Oct 21, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 19497 PR
Student in an Organized Health Care Education/Training Program 390200000X 13989I PR
Internal Medicine Physician 207R00000X 19497 PR Primary

Addresses

Primary practice location

431 Tulane
Vega Baja, PR 00693

Mailing address

431 Tulane
Vega Baja, PR 00693

Other identifiers 1

IdentifierTypeStateIssuer
1356713176MedicaidPR

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
I20211122003152 PR Practitioner - Internal Medicine 5698164135 Practice locations: Fajardo, PR; San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Calle Casia
San Juan, PR 00921-3200
Phone (787) 641-7582

151 Ave Osvaldo Molina
Fajardo, PR 00738-4013
Phone (787) 801-0081

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19497PRMDGeneral Practice Physician
13989IPRMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Caribe Physicians Plaza Corporation Past Accepting new patients
Fajardo Integrated Medical Center Past Accepting new patients

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": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1356713176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 TULANE",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 TULANE",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00693",
            "telephone_number": "787-382-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO FUENTES",
        "first_name": "HECTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-21",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19497",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "13989I",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "19497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356713176",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

Verify at the official NPI Registry.