NPIMap

Individual provider Active NPI

Carlos E Sepulveda Jr., D.P.M.

  • Podiatrist
  • Carolina, PR
National Provider Identifier
1407840325
Registry record updated Feb 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00085 Issued in PR
Practice address
Calle 22 15 # 37 Sabana Gardens
Carolina, PR 00983
Phone
(787) 361-9626
NPI assigned
Sep 7, 2005
Last updated
Feb 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 00085 PR Primary

Addresses

Primary practice location

Calle 22 15 # 37 Sabana Gardens
Carolina, PR 00983

Mailing address

Urb. Sabana Gardens Calle 22
15 # 37
Carolina, PR 00983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040417000264 PR Practitioner - Podiatry 1254326499 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cossma, Inc. CurrentSince Sep 4, 2013 Accepting new patients
Cossma Inc CurrentSince Sep 4, 2013 Accepting new patients
La Vida Medical Group Hatillo Corp Podiatrist Past Accepting new patients
Psychological Empowerment LLC Past Accepting new patients
La Vida Medical Group Hatillo Corp Past Accepting new patients
MMS Medical Services Group Corp Past Accepting new patients
CSM Servicios de Cuidado Inc. Past Accepting new patients
Rca Psychotherapeutic Group Inc Podiatrist Past Accepting new patients
CRM Group Practice Past Accepting new patients
Health Care Rehab. Group Past Accepting new patients

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1407840325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. SABANA GARDENS CALLE 22",
            "address_2": "15 # 37",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 22 15 # 37 SABANA GARDENS",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00983",
            "telephone_number": "787-361-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPULVEDA",
        "first_name": "CARLOS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PR",
            "license": "00085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.