Sergio Chevere Mourino, M.D.
Individual provider Active NPI Geriatric Medicine (Family Medicine) Physician · Ponce, PR
NPI 1528038973 · NPPES record last updated Feb 2, 2017
Key facts
- NPI
- 1528038973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Family Medicine) Physician 207QG0300X
- License
- 8150 (PR)
- Practice address
- 607 Calle Ferrocarril
Esq. Torres
Ponce, PR 00717 - Phone
- (787) 844-0331
- Fax
- (787) 840-8874
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Geriatric Medicine
- Education
- Ponce School of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Primary Medical Group CSP
Primary Medical Center Inc
Practice addresses (Care Compare)
607 Calle Ferrocarril
Ponce, PR 00717-1110
Phone (787) 259-7219
PO Box
Suite 336149
Ponce, PR 00733-6149
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120828000662 | PR | Practitioner - Geriatric Medicine |
9739220492 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8150 | PR | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Medical Center, Inc | Current |
Accepting new patients | |
| Primary Medical Group, C.S.P. | Current |
Accepting new patients | |
| Primary Medical Group,C.S.P. | Geriatric Medicine | Current |
Accepting new patients |
| Primary Medical Center Inc | Geriatric Medicine | Current |
Accepting new patients |
Locations
607 Calle Ferrocarril
Ponce, PR 00717
Phone (787) 259-7219
607 Calle Ferrocarril
Ste 101
Ponce, PR 00717
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 8150 | PR | Yes |
Addresses
Primary practice location
607 Calle Ferrocarril
Esq. Torres
Ponce, PR 00717
Mailing address
PO Box 336149
Ponce, PR 00733-6149
Phone (787) 844-0331
Other providers in Ponce, PR
- Ariel Chardon
- Domingo Chardon
- Maria de Begona Chavarri-Arzamendi
- German Chaves
- Eduardo Chavez
- Chiquirimundi Inc
- Chiquirimundi Medical LLC
- Gustavo Adolfo Christian
- Jacqueline Christian
- Andres Chuecos
All providers in Ponce, PR · Geriatric Medicine (Family Medicine) Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.