Individual provider Active NPI

Mariela Marquez Pantoja, M.D.

  • Nephrology Physician
  • Juncos, PR
National Provider Identifier
1376978098
Registry record updated Jul 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
19598 Issued in PR
Practice address
26 Calle Martinez
Juncos, PR 00777-3502
Phone
(787) 734-8042
NPI assigned
Sep 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2019

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 29470R PR
Nephrology Physician 207RN0300X 19598 PR Primary

Addresses

Primary practice location

26 Calle Martinez
Juncos, PR 00777-3502

Mailing address

PO Box 1819
Juncos, PR 00777-1819
Phone (787) 226-9182

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
I20190628000908 PR Practitioner - NephrologyPractitioner - Internal Medicine 6002140720 Practice locations: Juncos, PR

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26 Calle Martinez
Juncos, PR 00777-3502
Phone (787) 734-8042

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29470RPRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564272000000",
    "number": "1376978098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1819",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007771819",
            "telephone_number": "787-226-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CALLE MARTINEZ",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007773502",
            "telephone_number": "787-734-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ PANTOJA",
        "first_name": "MARIELA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2019-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "29470R",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PR",
            "license": "19598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juncos, PR

Sources for this page

Verify at the official NPI Registry.