Individual provider Active NPI

Ivelisse Benitez

  • Registered Nurse
  • San Juan, PR
National Provider Identifier
1396284618
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
78391 Issued in PR
Practice address
151 Calle Pachin Marin
Barriada Buena Vista
San Juan, PR 00917
Phone
(787) 387-3303
Fax
(787) 723-6247
NPI assigned
Feb 20, 2017
Last updated
Feb 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 78391 PR Primary

Addresses

Primary practice location

151 Calle Pachin Marin
Barriada Buena Vista
San Juan, PR 00917

Mailing address

151 Calle Pachin Marin
Barriada Buena Vista
San Juan, PR 00917-1412
Phone (787) 387-3303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
78391PRMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1396284618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 CALLE PACHIN MARIN",
            "address_2": "BARRIADA BUENA VISTA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009171412",
            "telephone_number": "787-387-3303",
            "fax_number": "787-723-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 CALLE PACHIN MARIN",
            "address_2": "BARRIADA BUENA VISTA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-387-3303",
            "fax_number": "787-723-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "IVELISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "78391",
            "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 Feb 20, 2017; 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.