Individual provider Active NPI

Mauricio Ehlert-Birriel, M.D.

  • General Practice Physician
  • Hato Rey, PR
National Provider Identifier
1366795379
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
18594 Issued in PR
Practice address
Hospital Auxilio Mutuo
Ave. Ponce de Leon
Hato Rey, PR 00918
Phone
(787) 758-2000
NPI assigned
Oct 16, 2012
Last updated
Aug 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 30927 NE
General Practice Physician 208D00000X 18594 PR Primary

Addresses

Primary practice location

Hospital Auxilio Mutuo
Ave. Ponce de Leon
Hato Rey, PR 00918

Mailing address

2000 Ave Dona Felisa Rincon de Apt 308
Cond Colina Real
San Juan, PR 00926-6645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160202001524 TX Practitioner - Emergency MedicinePractitioner - General Practice 5799088795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Plains Tribal Chairmen's Health BoardGroup PAC ID 0648609917, 64 clinicians

Practice addresses (Care Compare)

3200 Canyon Lake Dr
Rapid City, SD 57702-8114
Phone 60535525002356

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18594PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kayenta Alternative Rural Hospital CurrentSince Nov 7, 2024 Accepting new patients
Kayenta Alternative Rural Hospital CurrentSince Nov 7, 2024 Accepting new patients
Great Plains Tribal Chairmen's Health Board CurrentSince Mar 1, 2020 Accepting new patients
Kayenta Alternative Rural Hospital Current Accepting new patients

Locations

3200 Canyon Lake Dr
Rapid City, SD 57702
Phone (605) 355-2282

3200 Canyon Lake Dr
Ste 1
Rapid City, SD 57702
Phone (605) 355-2500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1366795379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 AVE DONA FELISA RINCON DE APT 308",
            "address_2": "COND COLINA REAL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL AUXILIO MUTUO",
            "address_2": "AVE. PONCE DE LEON",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-758-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLERT-BIRRIEL",
        "first_name": "MAURICIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-16",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "30927",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hato Rey, PR

Sources for this page

Verify at the official NPI Registry.