Organization Active NPI

Grupo Fisiatrico Villa Carmen, CSP

  • Specialist
  • Caguas, PR
National Provider Identifier
1518175322
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
12556 Issued in PR
Legal business name
GRUPO FISIATRICO VILLA CARMEN, CSP
Practice address
Bayamon K 13
Villa Carmen
Caguas, PR 00725
Phone
(787) 743-8730
Fax
(787) 745-6133
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Authorized official

Name
Dr. Limary Rios Camacho
Title
Owner
Phone
(787) 743-8730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 12556 PR Primary

Addresses

Primary practice location

Bayamon K 13
Villa Carmen
Caguas, PR 00725

Mailing address

PO Box 9328
Caguas, PR 00726-9328
Phone (787) 743-8730

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121126000045 PR Part B Supplier - Clinic/Group Practice 3476704446 Receives reassigned benefits from 4 practitioners
Practice locations: Caguas, PR

National Provider Directory

National Provider Directory

Locations

K13 Calle Bayamon
Caguas, PR 00725
Phone (787) 743-0873

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1518175322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9328",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007269328",
            "telephone_number": "787-743-8730",
            "fax_number": "787-745-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BAYAMON K 13",
            "address_2": "VILLA CARMEN",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-743-8730",
            "fax_number": "787-745-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRUPO FISIATRICO VILLA CARMEN, CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "CAMACHO",
        "authorized_official_first_name": "LIMARY",
        "authorized_official_middle_name": "RIOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-743-8730",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "12556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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.