Individual provider Active NPI

Lianette M Perez Colon, MD

  • Obstetrics & Gynecology Physician
  • Caguas, PR
National Provider Identifier
1518061969
Registry record updated Aug 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
13503 Issued in PR
Practice address
500 Ave Degetau
Hima Plaza Suite 414
Caguas, PR 00725
Phone
(787) 258-0614
Fax
(787) 961-4663
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 13503 PR Primary

Addresses

Primary practice location

500 Ave Degetau
Hima Plaza Suite 414
Caguas, PR 00725

Mailing address

100 Gran Bulevar Paseos
Suite 112 MSC 457
San Juan, PR 00926
Phone (787) 258-0614

Other identifiers 1

IdentifierTypeStateIssuer
0020321OtherPRPTAN

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
I20120306000836 PR Practitioner - Obstetrics/Gynecology 6204095532 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13503PRMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Caribbean OBGYN Institute, PSC Obstetrics & Gynecology Past Accepting new patients
Innovative GYN P.S.C. Past Accepting new patients

Organizations & group practices 2

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503878400000",
    "number": "1518061969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GRAN BULEVAR PASEOS",
            "address_2": "SUITE 112 MSC 457",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-258-0614",
            "fax_number": "787-961-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 AVE DEGETAU",
            "address_2": "HIMA PLAZA SUITE 414",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-258-0614",
            "fax_number": "787-961-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ COLON",
        "first_name": "LIANETTE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2017-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PR",
            "license": "13503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0020321",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.