Organization Active NPI

Colon Cancer Care LLC

  • Hematology & Oncology Physician
  • San Juan, PR
National Provider Identifier
1417770942
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
COLON CANCER CARE LLC
Practice address
405 Calle German Moyer
San Juan, PR 00918-2679
Phone
(787) 607-1502
NPI assigned
Nov 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Dr. Miguel Angel Colon Donate, MDNPI 1609262781
Title
MD
Phone
(787) 607-1502

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
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

405 Calle German Moyer
San Juan, PR 00918-2679

Mailing address

36 Calle Vereda Urb Monte Verde Real
San Juan, PR 00926-5984
Phone (787) 607-1502

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250115001365 PR Part B Supplier - Clinic/Group Practice 8022546241 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

405 Calle German Moyer
San Juan, PR 00918
Phone (787) 607-1502

Practitioners & affiliated clinicians

Practitioners 2

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": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1417770942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 CALLE VEREDA URB MONTE VERDE REAL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265984",
            "telephone_number": "787-607-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CALLE GERMAN MOYER",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009182679",
            "telephone_number": "787-607-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLON CANCER CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "COLON DONATE",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "ANGEL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "787-607-1502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.