Individual provider Active NPI

Jose G Fourquet, M.D.

  • Specialist
  • Guayama, PR
National Provider Identifier
1417040957
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
12020 Issued in PR
Practice address
Calle 1#1
Urb. Gibraltar
Guayama, PR 00784
Phone
(787) 866-7740
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 12020 PR Primary

Addresses

Primary practice location

Calle 1#1
Urb. Gibraltar
Guayama, PR 00784

Mailing address

Calle 1 a#6
Urb. Vista Mar
Guayama, PR 00784
Phone (787) 613-9325

Other identifiers 2

IdentifierTypeStateIssuer
22145FOOtherPRSSS
2-12020OtherPRMCS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12020PRMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Menonita Ponce 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417040957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE 1 A#6",
            "address_2": "URB. VISTA MAR",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-613-9325",
            "fax_number": "787-866-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 1#1",
            "address_2": "URB. GIBRALTAR",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-866-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURQUET",
        "first_name": "JOSE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "12020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "22145FO",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCS",
            "identifier": "2-12020",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guayama, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.