Individual provider Active NPI

Pedro Juan Amador, MD

  • Internal Medicine Physician
  • Ponce, PR
National Provider Identifier
1407851306
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13820 Issued in PR
Practice address
Concordia 8118 Suite 210
Galeria Profesional
Ponce, PR 00717-2027
Phone
(787) 841-4684
Fax
(787) 984-1231
NPI assigned
Jun 16, 2005
Last updated
Jun 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13820 PR Primary

Addresses

Primary practice location

Concordia 8118 Suite 210
Galeria Profesional
Ponce, PR 00717-2027

Mailing address

Concordia 8118 Suite 210
Ponce, PR 00717-2027
Phone (787) 841-4684

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
I20110601000636 PR Practitioner - Internal Medicine 7719164615 Practice locations: Ponce, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ponce School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8118
Suite 210
Ponce, PR 00717

Concordia
8118 Suite 210
Ponce, PR 00717
Phone (787) 841-4684

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ponce Medical School Foundation Inc Past Accepting new patients

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, 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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1407851306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CONCORDIA 8118 SUITE 210",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172027",
            "telephone_number": "787-841-4684",
            "fax_number": "787-984-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CONCORDIA 8118 SUITE 210",
            "address_2": "GALERIA PROFESIONAL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172027",
            "telephone_number": "787-841-4684",
            "fax_number": "787-984-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMADOR",
        "first_name": "PEDRO",
        "middle_name": "JUAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "13820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.