Individual provider Active NPI

Graciela Latalladi Ortega, M.D

  • Internal Medicine Physician
  • Bayamon, PR
National Provider Identifier
1366626921
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17004 Issued in PR
Practice address
73 Edificio Medico Santa Cruz
Ste 215
Bayamon, PR 00961
Phone
(787) 930-4845
NPI assigned
Dec 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 17004 PR
Pulmonary Disease Physician 207RP1001X 17004 PR
Internal Medicine Physician 207R00000X 17004 PR Primary

Addresses

Primary practice location

73 Edificio Medico Santa Cruz
Ste 215
Bayamon, PR 00961

Mailing address

32 Calle H
Urb. Villa Caparra Norte
Guaynabo, PR 00966
Phone (787) 930-4845

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
I20111110000083 PR Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 8325211212 Reassigns benefits to 2 organizations
Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

73 Calle Santa Cruz
Bayamon, PR 00961-6910
Phone (787) 930-4843

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17004PRMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc CurrentSince Aug 1, 2014 Accepting new patients
Pro-Health Clinical Services LLC CurrentSince Dec 4, 2016 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Aug 1, 2014 Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

Organizations & group practices 3

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 1

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": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1366626921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 CALLE H",
            "address_2": "URB. VILLA CAPARRA NORTE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00966",
            "telephone_number": "787-930-4845",
            "fax_number": "787-537-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 EDIFICIO MEDICO SANTA CRUZ",
            "address_2": "STE 215",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-930-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATALLADI ORTEGA",
        "first_name": "GRACIELA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PR",
            "license": "17004",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PR",
            "license": "17004",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "17004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.