Individual provider Active NPI

Maxuel E. Genao Encarnacion, M.D.

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1366438434
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
11201 Issued in PR
Practice address
Za1 Calle 36
Urb. Riverview
Bayamon, PR 00961-3929
Phone
(787) 785-2694
Fax
(787) 787-3109
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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 11201 PR Primary

Addresses

Primary practice location

Za1 Calle 36
Urb. Riverview
Bayamon, PR 00961-3929

Mailing address

PO Box 50027
Toa Baja, PR 00950-0027
Phone (787) 785-2694

Other identifiers 1

IdentifierTypeStateIssuer
87629OtherPRTRIPLE-S

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
I20120829000579 PR Practitioner - General Practice 4284881020 Reassigns benefits to 1 organization
Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Foundation of Puerto Rico Inc.Group PAC ID 6002046786, 6 clinicians

Practice addresses (Care Compare)

Marginal Santa Cruz
17 Urb Santa Cruz
Bayamon, PR 00961-6706
Phone (787) 780-1273

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11201PRMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Foundation of Puerto Rico, Inc. General Practice CurrentSince Aug 1, 2015 Accepting new patients
Community Health Foundation of Puerto Rico, Inc. CurrentSince Aug 1, 2015 Accepting new patients
Riverview Cardiovascular Services CSP PastSince Feb 1, 2008 Accepting new patients
Riverview Medical Services, Inc. General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1366438434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50027",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009500027",
            "telephone_number": "787-785-2694",
            "fax_number": "787-787-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ZA1 CALLE 36",
            "address_2": "URB. RIVERVIEW",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009613929",
            "telephone_number": "787-785-2694",
            "fax_number": "787-787-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENAO ENCARNACION",
        "first_name": "MAXUEL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "11201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE-S",
            "identifier": "87629",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.