Individual provider Active NPI

Idelvais M Pinero, MD

  • Gynecology Physician
  • San Juan, PR
National Provider Identifier
1407110372
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
19309 Issued in PR
Practice address
10 Calle Casia
San Juan, PR 00921-3200
Phone
(787) 641-7582
NPI assigned
Jun 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 19309 PR
Gynecology Physician 207VG0400X 19309 PR Primary

Addresses

Primary practice location

10 Calle Casia
San Juan, PR 00921-3200

Mailing address

144 Turquesa Urb Golden Gate
Guaynabo, PR 00968

Other practice location 1

Urb Turabo Gardens carretera 172
Caguas, PR 00726-4220
Phone (787) 653-0550

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
I20161012000821 PR Practitioner - Obstetrics/Gynecology 0941598692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Puerto Rico School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7 Calle Casia
San Juan, PR 00921-3200
Phone (939) 600-1144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19309PRMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Idelvais M Pinero Melendez Obstetrics & Gynecology PSC Obstetrics & Gynecology CurrentSince Apr 8, 2019 Accepting new patients

Locations

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

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

Organizations & group practices 1

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1407110372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 TURQUESA URB GOLDEN GATE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CALLE CASIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213200",
            "telephone_number": "787-641-7582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Urb Turabo Gardens carretera 172",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "007264220",
            "country_code": "US",
            "telephone_number": "787-653-0550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINERO",
        "first_name": "IDELVAIS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PR",
            "license": "19309",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "PR",
            "license": "19309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.