Individual provider Active NPI

Carissa Marie Cruz Berrios, M.D.

  • Pulmonary Disease Physician
  • Humacao, PR
National Provider Identifier
1366631665
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
16915 Issued in PR
Practice address
E2 Boulevard Office Plaza
Humacao, PR 00791
Phone
(787) 402-0262
Fax
(939) 697-6127
NPI assigned
Oct 23, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16915 PR
Pulmonary Disease Physician 207RP1001X 16915 PR Primary

Addresses

Primary practice location

E2 Boulevard Office Plaza
Humacao, PR 00791

Mailing address

G5 Calle Florencia Ave Rafael Cordero
Urb Caguas Norte
Caguas, PR 00725
Phone (787) 402-0262

Other practice location 1

A9 Calle Ilusion
Horizontes
Gurabo, PR 00778-4034
Phone (787) 315-4544

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
I20140210000498 PR Practitioner - Pulmonary Disease 6406085638 Practice locations: Caguas, PR

National Provider Directory

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

Organizations & group practices 1

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": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1366631665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G5 CALLE FLORENCIA AVE RAFAEL CORDERO",
            "address_2": "URB CAGUAS NORTE",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-402-0262",
            "fax_number": "939-697-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E2 BOULEVARD OFFICE PLAZA",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-402-0262",
            "fax_number": "939-697-6127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "A9 Calle Ilusion",
            "address_2": "Horizontes",
            "address_purpose": "LOCATION",
            "city": "Gurabo",
            "state": "PR",
            "postal_code": "007784034",
            "country_code": "US",
            "telephone_number": "787-315-4544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ BERRIOS",
        "first_name": "CARISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "16915",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PR",
            "license": "16915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.