Individual provider Active NPI

Mervin Sanchez-Maldonado

  • Health Maintenance Organization
  • Aguadilla, PR
National Provider Identifier
1396310439
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Practice address
536 Ave Victoria Ubr Garcia
Aguadilla, PR 00603
Phone
(787) 658-6218
Fax
(787) 658-7116
NPI assigned
May 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X PR Primary

Addresses

Primary practice location

536 Ave Victoria Ubr Garcia
Aguadilla, PR 00603

Mailing address

Urb Monte Claro Ma-36
Plaza 7
Bayamon, PR 00961
Phone (787) 658-6218

Other practice location 1

B11 Calle Santa Cruz
Bayamon, PR 00961-6955
Phone (787) 658-6218

Other identifiers 1

IdentifierTypeStateIssuer
70MedicaidPR

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL SYNC

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Dr. Hector Tirado CSP Current Accepting new patients
Asociacion de Medicos de Puerto Rico Ms Inc CurrentSince Aug 14, 2022 Accepting new patients
Asociacion de Medicos de Puerto Rico Ms Inc Health Maintenance Organization CurrentSince Jun 21, 2020 Accepting new patients
Asociacion de Medicos de PR Ms Inc Health Maintenance Organization Current Accepting new patients

Locations

536 Ave Victoria
Aguadilla, PR 00603
Phone (787) 509-7401

B11 Calle Santa Cruz
Bayamon, PR 00961
Phone (787) 658-6218

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1396310439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB MONTE CLARO MA-36",
            "address_2": "PLAZA 7",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-658-6218",
            "fax_number": "787-658-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 AVE VICTORIA UBR GARCIA",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-658-6218",
            "fax_number": "787-658-7116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "B11 Calle Santa Cruz",
            "address_purpose": "LOCATION",
            "city": "Bayamon",
            "state": "PR",
            "postal_code": "009616955",
            "country_code": "US",
            "telephone_number": "787-658-6218",
            "fax_number": "787-658-7116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ-MALDONADO",
        "first_name": "MERVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SYNC",
            "affiliation": "N",
            "address_1": "536 AVE VICTORIA UBR GARCIA",
            "city": "AGUADILLA",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aguadilla, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.