Individual provider Active NPI

Mary Carmen Quiles, MD

  • Internal Medicine Physician
  • Dorado, PR
National Provider Identifier
1487130910
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22326 Issued in PR
Practice address
Carr 696 Ave Efron
Dorado, PR 00646-0064
Phone
(787) 625-3030
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22326 PR Primary

Addresses

Primary practice location

Carr 696 Ave Efron
Dorado, PR 00646-0064

Mailing address

143 Calle Nardo
Toa Alta, PR 00953-3685
Phone (787) 425-7803

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
I20220726002269 PR Practitioner - Internal Medicine 9133501935 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carretera
21 1785 Las Lomas
San Juan, PR 00922-0022
Phone (787) 782-9999

Hospital & facility affiliations

  • Corporacion Las Vegas, LLC Home health agency, Manati, PR, CCN 407014
  • Hospicio Luz de Esperanza Inc Hospice, Manati, PR, CCN 401574
  • Doctors Center Hospital Orlando Health Dorado Hospital, Dorado, PR, CCN 400137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22326PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Haz LLC Internal Medicine CurrentSince Nov 16, 2024 Accepting new patients
SHC Owner LLC Past Accepting new patients

Locations

900 Carr 696
Dorado, PR 00646
Phone 78762550508127

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1487130910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 CALLE NARDO",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009533685",
            "telephone_number": "787-425-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 696 AVE EFRON",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006460064",
            "telephone_number": "787-625-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILES",
        "first_name": "MARY",
        "middle_name": "CARMEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "22326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

Verify at the official NPI Registry.