Individual provider Active NPI

Marcos Eliud Natal Deliz, MD

  • General Practice Physician
  • Manati, PR
National Provider Identifier
1427720754
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22843 Issued in PR
Practice address
5 Carr 2 # KM
Manati, PR 00674-4894
Phone
(787) 854-2292
NPI assigned
Oct 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 22843 PR Primary

Addresses

Primary practice location

5 Carr 2 # KM
Manati, PR 00674-4894

Mailing address

169 Calle Sirena
Hatillo, PR 00659-2769

Other identifiers 1

IdentifierTypeStateIssuer
22843MedicaidPR

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
I20240514000878 PR Practitioner - General Practice 0648611202 Practice locations: Manati, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22843PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1427720754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 CALLE SIRENA",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006592769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CARR 2 # KM",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006744894",
            "telephone_number": "787-854-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATAL DELIZ",
        "first_name": "MARCOS",
        "middle_name": "ELIUD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22843",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.