Abg Advanced Gastro Group LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

ABG ADVANCED GASTRO GROUP LLC

Practice address

1451 Ave Ashford
San Juan, PR 00907-1511

Phone

(787) 721-2160

NPI assigned

Aug 6, 2024

Organization subpart

No

Name

Dr. Aliana M Bofill Garcia, MDNPI 1902292238

Title

President

Phone

(787) 370-2513

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

• Aliana M Bofill-Garcia, MD

  • Gastroenterology Physician
  • Rochester, MN
  • NPI 1902292238

  Gastroenterology, PR

  Medicare reassignment NPD Authorized official
• Walisbeth Class-Vazquez

  • Gastroenterology Physician
  • San Juan, PR
  • NPI 1518302652

  Single Specialty

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 6, 2024.

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1548090210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB TIERRA ALTA II",
            "address_2": "P6 CALLE LAS PALOMAS",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009693244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 AVE ASHFORD",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071511",
            "telephone_number": "787-721-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABG ADVANCED GASTRO GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "BOFILL GARCIA",
        "authorized_official_first_name": "ALIANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-370-2513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Manuel Eduardo Abraham Gonzalez, M.D.
• Jennifer Abraham Vega, MD
• Nicole Abrams Santiago, PHARMD

• All providers in San Juan, PR
• Gastroenterology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.