Active NPI
Jose Antonio Pacheco Suarez, M.D.
- Diagnostic Radiology Physician
- San Juan, PR
National Provider Identifier
1457538159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 018127
- Practice address
- 1511 Ave Ponce de Leon
Apt 176
San Juan, PR 00909-5001 - Phone
- (952) 595-1100
- Fax
- (612) 294-4903
- NPI assigned
- Jan 24, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 018127 | PR | Primary |
Addresses
Primary practice location
1511 Ave Ponce de Leon
Apt 176
San Juan, PR 00909-5001
Mailing address
1511 Ave Ponce de Leon
Ciudadela Apt # 176
San Juan, PR 00909-5001
Phone (787) 502-8020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EQ104Y | Other | PR | MEDICARE PTAN |
Other names 1
- Jose A Pacheco Suarez
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018127 | PR | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ton Sells Hospital | Past | Accepting new patients | |
| Ton San Xavier Health Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Tucson, AZ
- NPI 1518905793
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Sells, AZ
- NPI 1699717785
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540771200000",
"number": "1457538159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1511 AVE PONCE DE LEON",
"address_2": "CIUDADELA APT # 176",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009095001",
"telephone_number": "787-502-8020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1511 AVE PONCE DE LEON",
"address_2": "APT 176",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009095001",
"telephone_number": "952-595-1100",
"fax_number": "612-294-4903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHECO SUAREZ",
"first_name": "JOSE",
"middle_name": "ANTONIO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-24",
"last_updated": "2018-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "PR",
"license": "018127",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "EQ104Y",
"state": "PR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JOSE",
"last_name": "PACHECO SUAREZ",
"middle_name": "A",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}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 Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.