Individual provider Active NPI

Manuel A Brignoni Roman, MD

  • Psychiatry Physician
  • Ponce, PR
National Provider Identifier
1427047760
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
9934 Issued in PR
Practice address
Calle Concodia #8118
Galena Profesional Suite 105
Ponce, PR 00717-1589
Phone
(787) 844-3067
NPI assigned
Oct 19, 2005
Last updated
Mar 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 9934 PR Primary

Addresses

Primary practice location

Calle Concodia #8118
Galena Profesional Suite 105
Ponce, PR 00717-1589

Mailing address

Calle Concodia #8118
Galena Profesional Suite 105
Ponce, PR 00717-1589
Phone (787) 844-3067

Other identifiers 1

IdentifierTypeStateIssuer
88965BROtherSSS

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
I20060120000649 PR Practitioner - Psychiatry 4789608498 Practice locations: Ponce, PR

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Calle Concordia
8118 Galeria Profesional Suite 105
Ponce, PR 00717-1589

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9934PRMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1427047760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE CONCODIA #8118",
            "address_2": "GALENA PROFESIONAL SUITE 105",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171589",
            "telephone_number": "787-844-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE CONCODIA #8118",
            "address_2": "GALENA PROFESIONAL SUITE 105",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171589",
            "telephone_number": "787-844-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGNONI ROMAN",
        "first_name": "MANUEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "9934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "88965BR",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.