Individual provider Active NPI

Angel Luis Soto, MD, MPH

  • General Practice Physician
  • Guaynabo, PR
National Provider Identifier
1508893777
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
13644 Issued in PR
Practice address
90 Carr 165 Ste 504
Guaynabo, PR 00968-8067
Phone
(787) 708-6777
Fax
(787) 708-6779
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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 13644 PR Primary

Addresses

Primary practice location

90 Carr 165 Ste 504
Guaynabo, PR 00968-8067

Mailing address

90 Carr 165 Ste 504
Guaynabo, PR 00968-8067
Phone (787) 708-7777

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
I20070222000020 PR Practitioner - General Practice 9830291830 Practice locations: Guaynabo, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13644PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
S & S Healthcare Services Inc. Past Accepting new patients
S & S Healthcare Services Inc. Past Accepting new patients
Centro Diangostico Integral PR Inc Past Accepting new patients

Organizations & group practices 3

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1508893777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CARR 165 STE 504",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009688067",
            "telephone_number": "787-708-7777",
            "fax_number": "787-708-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CARR 165 STE 504",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009688067",
            "telephone_number": "787-708-6777",
            "fax_number": "787-708-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO",
        "first_name": "ANGEL",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "13644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.