Individual provider Active NPI

Luis M Irizarry-Pabon

  • Internal Medicine Physician
  • Coto Laurel, PR
National Provider Identifier
1508822370
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9154 Issued in PR
Practice address
Torre San Cristobal
Ste 209
Coto Laurel, PR 00780
Phone
(787) 259-0988
NPI assigned
Apr 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 9154 PR Primary

Addresses

Primary practice location

Torre San Cristobal
Ste 209
Coto Laurel, PR 00780

Mailing address

PO Box 800572
Coto Laurel, PR 00780-0572

Other identifiers 1

IdentifierTypeStateIssuer
80675MedicaidPR

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
I20110330000860 PR Practitioner - Internal Medicine 6406039387 Reassigns benefits to 1 organization
Practice locations: Coto Laurel, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Puerto Rico School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PR 506 Torre San Cristobal
Suite 209
Coto Laurel, PR 00780
Phone (787) 259-0988

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9154PRMDInternal Medicine Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508822370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800572",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007800572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TORRE SAN CRISTOBAL",
            "address_2": "STE 209",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "00780",
            "telephone_number": "787-259-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRIZARRY-PABON",
        "first_name": "LUIS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "9154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80675",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coto Laurel, PR

Sources for this page

Verify at the official NPI Registry.