NPIMap

Organization Active NPI

La Plata Medical Group

  • Point of Service
  • San Juan, PR
National Provider Identifier
1366650095
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Legal business name
LA PLATA MEDICAL GROUP
Practice address
1551 Calle Alda
Suite 201 Urb. Caribe
San Juan, PR 00926-2709
Phone
(787) 281-0810
Fax
(787) 474-3051
NPI assigned
May 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Roberto Luis Bengoa
Title
President
Phone
(787) 281-0810

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X Primary

Addresses

Primary practice location

1551 Calle Alda
Suite 201 Urb. Caribe
San Juan, PR 00926-2709

Mailing address

1551 Calle Alda
Suite 201 Urb. Caribe
San Juan, PR 00926-2709
Phone (787) 281-0810

National Provider Directory

National Provider Directory
Tax ID family
La Plata Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366650095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 CALLE ALDA",
            "address_2": "SUITE 201 URB. CARIBE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009262709",
            "telephone_number": "787-281-0810",
            "fax_number": "787-474-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 CALLE ALDA",
            "address_2": "SUITE 201 URB. CARIBE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009262709",
            "telephone_number": "787-281-0810",
            "fax_number": "787-474-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PLATA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENGOA",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-281-0810"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Aug 22, 2020; 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.