Active NPI
Carlos Andres Guevara Serra
- General Practice Physician
- San Juan, PR
National Provider Identifier
1366074643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 16380
- Practice address
- Paseo Dr. Jose Celso Barbosa
San Juan, PR 00921 - Phone
- (787) 758-2525
- NPI assigned
- Feb 5, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Physician | 208D00000X | 16380 | PR | Primary |
Addresses
Primary practice location
Paseo Dr. Jose Celso Barbosa
San Juan, PR 00921
Mailing address
Estancias Reales Calle Principe Andres 46
Guaynabo, PR 00969
Phone (787) 479-0156
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16380 | PR | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666137600000",
"number": "1366074643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ESTANCIAS REALES CALLE PRINCIPE ANDRES 46",
"city": "GUAYNABO",
"state": "PR",
"postal_code": "00969",
"telephone_number": "787-479-0156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PASEO DR. JOSE CELSO BARBOSA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00921",
"telephone_number": "787-758-2525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUEVARA SERRA",
"first_name": "CARLOS",
"middle_name": "ANDRES",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-05",
"last_updated": "2022-10-19",
"certification_date": "2022-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "16380",
"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 Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.