NPIMap

Organization Active NPI

Medicos Especializados de San Juan

  • Interventional Pain Medicine Physician
  • San Juan, PR
National Provider Identifier
1548574635
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
15828 Issued in PR
Legal business name
MEDICOS ESPECIALIZADOS DE SAN JUAN
Practice address
576 Ave Cesar Gonzalez
Ste 508
San Juan, PR 00918
Phone
(787) 766-7070
NPI assigned
Jul 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Authorized official

Name
Dr. Alejandro Porrata, MD
Title
Owner
Phone
(787) 420-9259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X 15828 PR Primary

Addresses

Primary practice location

576 Ave Cesar Gonzalez
Ste 508
San Juan, PR 00918

Mailing address

PO Box 16698
San Juan, PR 00908-6698

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110613000373 PR Part B Supplier - Clinic/Group Practice 3779760160 Receives reassigned benefits from 5 practitioners
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

576 Calle Cesar Gonzalez
Ste 508
San Juan, PR 00918
Phone (787) 979-3444

1054 Ave Ashford
San Juan, PR 00907
Phone (787) 721-2250

Practitioners & affiliated clinicians

Practitioners 8

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": "1280448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1548574635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16698",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009086698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 AVE CESAR GONZALEZ",
            "address_2": "STE 508",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-766-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOS ESPECIALIZADOS DE SAN JUAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-30",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "PORRATA",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-420-9259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "PR",
            "license": "15828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.