Individual provider Active NPI

Wilson Torrens Peterson, M.D.

  • Family Medicine Physician
  • Vega Alta, PR
National Provider Identifier
1396888749
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9309 Issued in PR
Practice address
H39 Calle Marginal
Vega Alta, PR 00692-7402
Phone
(787) 883-6887
NPI assigned
Feb 15, 2007
Last updated
Apr 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9309 PR Primary

Addresses

Primary practice location

H39 Calle Marginal
Vega Alta, PR 00692-7402

Mailing address

H39 Calle Marginal
Vega Alta, PR 00692-7402
Phone (787) 883-6887

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
I20070426000530 PR Practitioner - General Practice 6608972377 Practice locations: Vega Alta, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9309PRMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1396888749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "H39 CALLE MARGINAL",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006927402",
            "telephone_number": "787-883-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "H39 CALLE MARGINAL",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006927402",
            "telephone_number": "787-883-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRENS PETERSON",
        "first_name": "WILSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "9309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Alta, PR

Sources for this page

Verify at the official NPI Registry.