Organization Active NPI

Gastroenterology and Cardiac Arrhythmia Service PSC

  • Gastroenterology Physician
  • Trujillo Alto, PR
National Provider Identifier
1497997555
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
15,987 Issued in PR
Legal business name
GASTROENTEROLOGY AND CARDIAC ARRHYTHMIA SERVICE PSC
Practice address
93 Paseo Herradura
Trujillo Alto, PR 00976-6068
Phone
(787) 390-9090
NPI assigned
Apr 2, 2009
Last updated
Apr 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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

Authorized official

Name
Dr. Luarde Isaac Montano, M.D.
Title
President
Phone
(787) 390-9090

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 13,964 PR
Gastroenterology Physician 207RG0100X 15,987 PR Primary

Addresses

Primary practice location

93 Paseo Herradura
Trujillo Alto, PR 00976-6068

Mailing address

93 Paseo Herradura
Trujillo Alto, PR 00976-6068
Phone (787) 390-9090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090821000178 PR Part B Supplier - Clinic/Group Practice 5698829802 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1497997555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 PASEO HERRADURA",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009766068",
            "telephone_number": "787-390-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 PASEO HERRADURA",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009766068",
            "telephone_number": "787-390-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY AND CARDIAC ARRHYTHMIA SERVICE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-02",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "MONTANO",
        "authorized_official_first_name": "LUARDE",
        "authorized_official_middle_name": "ISAAC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-390-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "PR",
            "license": "13,964",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "15,987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trujillo Alto, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; 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.