NPIMap

Individual provider Active NPI

Christian J. Fourquet Caraballo

  • Diagnostic Radiology Physician
  • New Haven, CT
National Provider Identifier
1497298525
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
74931 Issued in CT
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-2433
Fax
(203) 688-9258
NPI assigned
Nov 21, 2016
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 74931 CT Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

20 York St
New Haven, CT 06510-3220
Phone (203) 688-2433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240210000670 PR Practitioner - Diagnostic Radiology 0840650115 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ponce School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Center Hospital San JuanGroup PAC ID 3678639036, 11 clinicians
Doctors Center Hospital Bayamon IncGroup PAC ID 8123024056, 13 clinicians
Doctors Center Hospital IncGroup PAC ID 7810088796, 20 clinicians
SHC Owner, LLCGroup PAC ID 0446644934, 11 clinicians

Practice addresses (Care Compare)

1395 Calle San Rafael
San Juan, PR 00909-2518
Phone (787) 999-7620

Calle
9 Extension Hermanas Davilas
Bayamon, PR 00960
Phone (787) 622-5420

Carr 2 KM
Suite 7
Manati, PR 00674-8513
Phone (787) 854-3322

Edificio Jesus T Pinero Ave Fernandez
Bo Pueblo
Carolina, PR 00979
Phone (787) 626-3322

Road 696 Interseccion Ave Efron
Bo Higuillar
Dorado, PR 00646-5718
Phone (787) 625-5050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Care Services LLC CurrentSince Dec 31, 2023 Accepting new patients
SHC Owner LLC Diagnostic Radiology CurrentSince Dec 20, 2023 Accepting new patients
Doctors Center Hospital San Juan CurrentSince Dec 20, 2023 Accepting new patients
Doctors Center Hospital Carolina LLC Current Accepting new patients
Doctors Center Hospital San Juan CurrentSince Dec 20, 2023 Accepting new patients
Doctors Center Hospital Inc CurrentSince Dec 20, 2023 Accepting new patients
Doctors Center Hospital Bayamon Inc CurrentSince Dec 20, 2023 Accepting new patients
Doctors Center Hospital Carolina LLC CurrentSince Dec 20, 2023 Accepting new patients
Hospitalist Medical Services, PSC PastSince Dec 20, 2023 Accepting new patients

Locations

1395 Calle San Rafael
#20
Santurce, PR 00909
Phone 78785433221191

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1497298525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-2433",
            "fax_number": "203-688-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-2433",
            "fax_number": "203-688-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURQUET CARABALLO",
        "first_name": "CHRISTIAN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-21",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "74931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.