Organization Active NPI

CPR Cardio Care, CSP

  • Cardiovascular Disease Physician
  • Mayaguez, PR
National Provider Identifier
1407197502
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
7697 Issued in PR
Legal business name
CPR CARDIO CARE, CSP
Practice address
55 De Diego CPR Building
Suite 303-304
Mayaguez, PR 00681
Phone
(787) 833-6100
Fax
(787) 833-5980
NPI assigned
Mar 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Authorized official

Name
Miss Jessica Rodriguez Maldonado, BS
Title
Assistant
Phone
(787) 310-9812

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 7697 PR Primary

Addresses

Primary practice location

55 De Diego CPR Building
Suite 303-304
Mayaguez, PR 00681

Mailing address

PO Box 1522
Mayaguez, PR 00681-1522
Phone (787) 833-6100

Other identifiers 2

IdentifierTypeStateIssuer
1518925288OtherPRNPI
1518162890OtherPRNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140611000278 PR Part B Supplier - Clinic/Group Practice 7416171590 Receives reassigned benefits from 2 practitioners
Practice locations: Mayaguez, PR

National Provider Directory

National Provider Directory

Locations

55 Calle de Diego E
Ste 303304
Mayaguez, PR 00680
Phone (787) 833-6100

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374192000000",
    "number": "1407197502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1522",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006811522",
            "telephone_number": "787-833-6100",
            "fax_number": "787-833-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DE DIEGO CPR BUILDING",
            "address_2": "SUITE 303-304",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00681",
            "telephone_number": "787-833-6100",
            "fax_number": "787-833-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPR CARDIO CARE, CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2013-07-19",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ MALDONADO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "ASSISTANT",
        "authorized_official_telephone_number": "787-310-9812",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PR",
            "license": "7697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1518925288",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1518162890",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.