Individual provider Active NPI

Gerardo Luis Santiago-Alicea, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1407238751
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19754 Issued in PR
Practice address
550 Calle Sergio Cuevas Bustamente, Ave Domenech
San Juan, PR 00918
Phone
(787) 758-8383
Fax
(787) 763-9758
NPI assigned
Jun 23, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 19754 PR Primary

Addresses

Primary practice location

550 Calle Sergio Cuevas Bustamente, Ave Domenech
San Juan, PR 00918

Mailing address

100 Calle Alcala Apt 1702
San Juan, PR 00921-3928
Phone (787) 519-6526

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
I20180326000427 PR Practitioner - General PracticePractitioner - Emergency Medicine 7416219746 Reassigns benefits to 1 organization
Practice locations: Rio Grande, PR; San Juan, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc CurrentSince Oct 15, 2018 Accepting new patients
Centro Medico del Turabo Inc General Practice CurrentSince Oct 15, 2018 Accepting new patients

Locations

70 Calle Santa Cruz
Bayamon, PR 00961
Phone (787) 620-1639

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

Organizations & group practices 2

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502236800000",
    "number": "1407238751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CALLE ALCALA APT 1702",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213928",
            "telephone_number": "787-519-6526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CALLE SERGIO CUEVAS BUSTAMENTE, AVE DOMENECH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-758-8383",
            "fax_number": "787-763-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO-ALICEA",
        "first_name": "GERARDO",
        "middle_name": "LUIS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2017-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.