Individual provider Active NPI

Mayra Guma, RN

  • Registered Nurse
  • San Juan, PR
National Provider Identifier
1366101073
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
27219 Issued in PR
Practice address
11217 65TH Ave
San Juan, PR 00987
Phone
(787) 276-7191
NPI assigned
Dec 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 27219 PR Primary

Addresses

Primary practice location

11217 65TH Ave
San Juan, PR 00987

Mailing address

1785 Calle J Ferrer Y Ferrer Apt 310
San Juan, PR 00921-4185
Phone (787) 307-0551

Other identifiers 1

IdentifierTypeStateIssuer
0009MedicaidPR

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Website Health Information Exchange (HIE)

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
27219PRMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1366101073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 CALLE J FERRER Y FERRER APT 310",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009214185",
            "telephone_number": "787-307-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11217 65TH AVE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "787-276-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMA",
        "first_name": "MAYRA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "27219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Website",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "None",
            "address_1": "11217 65th Ave",
            "city": "San Juan",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.