Individual provider Active NPI

Emerito Ventura Sr., MD

  • General Practice Physician
  • Toa Alta, PR
National Provider Identifier
1366491391
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5109 Issued in PR
Practice address
G21 Calle 10
Urb Villa Matilde
Toa Alta, PR 00953-6902
Phone
(787) 870-7070
NPI assigned
May 8, 2006
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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 5109 PR Primary

Addresses

Primary practice location

G21 Calle 10
Urb Villa Matilde
Toa Alta, PR 00953-6902

Mailing address

420 Calle Verbena
Ciudad Jardin III
Toa Alta, PR 00953

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
I20060921000055 PR Practitioner - General Practice 2567467822 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Clinic of Caribbean, Inc General Practice CurrentSince Oct 1, 2020 Accepting new patients
Centro Imagenes Radiologia Toa Alta CurrentSince Oct 1, 2020 Accepting new patients

Locations

G21 Calle 10
Toa Alta, PR 00953
Phone (787) 870-7070

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, 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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1366491391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CALLE VERBENA",
            "address_2": "CIUDAD JARDIN III",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "00953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G21 CALLE 10",
            "address_2": "URB VILLA MATILDE",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009536902",
            "telephone_number": "787-870-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURA",
        "first_name": "EMERITO",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "5109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Alta, PR

Sources for this page

Verify at the official NPI Registry.