Individual provider Active NPI

Kenneth Willard Brewster III, M.D.

  • General Practice Physician
  • Fajardo, PR
National Provider Identifier
1508809708
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16048 Issued in PR
Practice address
303 Ave General Valero
Fajardo, PR 00738-4844
Phone
(787) 655-0459
Fax
(754) 206-8506
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16048 PR Primary

Addresses

Primary practice location

303 Ave General Valero
Fajardo, PR 00738-4844

Mailing address

462 Paseo Hermoso
Canovanas, PR 00729-9891
Phone (787) 948-3435

Other identifiers 1

IdentifierTypeStateIssuer
16048OtherPRMEDICAL LICENSE

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
I20060731000255 PR Practitioner - General Practice 5799798294 Reassigns benefits to 1 organization
Practice locations: Fajardo, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

59 Calle Santiago W
Fajardo, PR 00738-4757
Phone (787) 655-0459

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16048PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc General Practice CurrentSince Oct 14, 2012 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Oct 14, 2012 Accepting new patients
Sar Medical Services LLC General Practice Past Accepting new patients
Healthcare Ambulatory Services Inc. Past Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1508809708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 PASEO HERMOSO",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007299891",
            "telephone_number": "787-948-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 AVE GENERAL VALERO",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007384844",
            "telephone_number": "787-655-0459",
            "fax_number": "754-206-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWSTER",
        "first_name": "KENNETH",
        "middle_name": "WILLARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "16048",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

Verify at the official NPI Registry.