Organization Active NPI

Neurocritical Care Physician

  • Neurocritical Care Physician
  • Caguas, PR
National Provider Identifier
1407629918
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
Legal business name
NEUROCRITICAL CARE PHYSICIAN
Practice address
Hospital Metro Pavia
100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone
(787) 653-3434
NPI assigned
Nov 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Hiram J Maldonado Quintana, MDNPI 1942570064
Title
President
Phone
(787) 248-0342

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A2900X Primary

Addresses

Primary practice location

Hospital Metro Pavia
100 Ave Luis Munoz Marin
Caguas, PR 00725

Mailing address

PO Box 333
Carolina, PR 00986-0333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231221004177 PR Part B Supplier - Clinic/Group Practice 4981054574 Receives reassigned benefits from 5 practitioners
Practice locations: Caguas, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1407629918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 333",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009860333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL METRO PAVIA",
            "address_2": "100 AVE LUIS MUNOZ MARIN",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-653-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROCRITICAL CARE PHYSICIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "MALDONADO QUINTANA",
        "authorized_official_first_name": "HIRAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-248-0342",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.