Active NPI
Lyssette J Maldonado, M.D.
- Pediatrics Physician
- San Juan, PR
National Provider Identifier
1427017136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 12415
- Practice address
- 1451 Ashford Ave Condado
Hospital Ashford
San Juan, PR 00907 - Phone
- (787) 722-6004
- Fax
- (787) 722-6003
- NPI assigned
- Mar 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 12415 | PR | Primary |
Addresses
Primary practice location
1451 Ashford Ave Condado
Hospital Ashford
San Juan, PR 00907
Mailing address
PO Box 11913
San Juan, PR 00922-1913
Phone (787) 999-0753
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12415 | PR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Community Hospital, 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.
-
- General Acute Care Hospital
- San Juan, PR
- NPI 1770580813
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547769600000",
"number": "1427017136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11913",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009221913",
"telephone_number": "787-999-0753",
"fax_number": "787-841-7228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1451 ASHFORD AVE CONDADO",
"address_2": "HOSPITAL ASHFORD",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00907",
"telephone_number": "787-722-6004",
"fax_number": "787-722-6003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "LYSSETTE",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-21",
"last_updated": "2019-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PR",
"license": "12415",
"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 Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.