Active NPI
Reyci Carrasco, MD
- General Practice Physician
- Bayamon, PR
National Provider Identifier
1396935540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 12987
- Practice address
- Urb. Estancias Calle Villa Caracas #B31
Bayamon, PR 00961 - Phone
- (787) 870-5374
- NPI assigned
- Jul 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 12987 | PR | Primary |
Addresses
Primary practice location
Urb. Estancias Calle Villa Caracas #B31
Bayamon, PR 00961
Mailing address
PMB 166
Box 1345
Toa Alta, PR 00954-1345
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12987 | PR | MD | Adolescent and Children Mental Health Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185321600000",
"number": "1396935540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PMB 166",
"address_2": "BOX 1345",
"city": "TOA ALTA",
"state": "PR",
"postal_code": "009541345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "URB. ESTANCIAS CALLE VILLA CARACAS #B31",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00961",
"telephone_number": "787-870-5374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRASCO",
"first_name": "REYCI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-25",
"last_updated": "2007-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "12987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayamon, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.