Organization Active NPI

Idelvais M Pinero Melendez Obstetrics & Gynecology PSC

  • Obstetrics & Gynecology Physician
  • San Juan, PR
National Provider Identifier
1396206686
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
IDELVAIS M PINERO MELENDEZ OBSTETRICS & GYNECOLOGY PSC
Practice address
1051 3 SE St la Riviera
Medical Center Plaza 8
San Juan, PR 00929
Phone
(939) 969-0900
NPI assigned
Mar 28, 2019
Last updated
Mar 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Authorized official

Name
Idelvais M Pinero, MDNPI 1407110372
Title
President
Phone
(939) 969-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

1051 3 SE St la Riviera
Medical Center Plaza 8
San Juan, PR 00929

Mailing address

144 Calle Turquesa
Guaynabo, PR 00968-3418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190521000895 PR Part B Supplier - Clinic/Group Practice 1759624430 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

7 Calle Casia
San Juan, PR 00921
Phone (939) 969-0900

7 Calle Casia
San Juan, PR 00921
Phone (939) 969-0900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1396206686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 CALLE TURQUESA",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009683418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 3 SE ST LA RIVIERA",
            "address_2": "MEDICAL CENTER PLAZA 8",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00929",
            "telephone_number": "939-969-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDELVAIS M PINERO MELENDEZ OBSTETRICS & GYNECOLOGY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "PINERO",
        "authorized_official_first_name": "IDELVAIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "939-969-0900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "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 Mar 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.