Individual provider Active NPI

Mabel Cedres, P.T.

  • Physical Therapist
  • San Juan, PR
National Provider Identifier
1487761946
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
377 Issued in PR
Practice address
Urb. El Cerezal 1614 Loira St.
San Juan, PR 00926-3034
Phone
(787) 767-6378
Fax
(787) 767-6378
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 377 PR Primary

Addresses

Primary practice location

Urb. El Cerezal 1614 Loira St.
San Juan, PR 00926-3034

Mailing address

Urb. El Cerezal 1614 Loira St.
San Juan, PR 00926-3034
Phone (787) 767-6378

Other names 1

  • Mabel Cedres Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061206000012 PR Practitioner - Physical Therapist in Private Practice 0143229906 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
377PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1487761946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. EL CEREZAL 1614 LOIRA ST.",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009263034",
            "telephone_number": "787-767-6378",
            "fax_number": "787-767-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. EL CEREZAL 1614 LOIRA ST.",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009263034",
            "telephone_number": "787-767-6378",
            "fax_number": "787-767-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEDRES",
        "first_name": "MABEL",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MABEL",
            "last_name": "CEDRES",
            "credential": "P.T.",
            "code": "1",
            "type": "Former 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 Sep 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.