Individual provider Active NPI

Nicolas M Perez Maldonado, M.D.

  • Neurology Physician
  • Bayamon, PR
National Provider Identifier
1558354829
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
10813 Issued in PR
Practice address
68 Calle Santa Cruz
Edif Torre San Pablo Suite 401
Bayamon, PR 00961-7031
Phone
(787) 785-2424
Fax
(787) 785-2425
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 10813 PR Primary

Addresses

Primary practice location

68 Calle Santa Cruz
Edif Torre San Pablo Suite 401
Bayamon, PR 00961-7031

Mailing address

68 Calle Santa Cruz
Edif Torre San Pablo Suite 401
Bayamon, PR 00961-7031
Phone (787) 785-2424

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
I20150220000810 PR Practitioner - Neurology 4880919505 Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Puerto Rico School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Rehabilitation Services IncGroup PAC ID 0345406187, shared by 2 NPIs, 51 clinicians

Practice addresses (Care Compare)

Uu43 Calle
Suite 30
Bayamon, PR 00956-4701
Phone (787) 787-8669

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10813PRMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1558354829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 CALLE SANTA CRUZ",
            "address_2": "EDIF TORRE SAN PABLO SUITE 401",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617031",
            "telephone_number": "787-785-2424",
            "fax_number": "787-785-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 CALLE SANTA CRUZ",
            "address_2": "EDIF TORRE SAN PABLO SUITE 401",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617031",
            "telephone_number": "787-785-2424",
            "fax_number": "787-785-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ MALDONADO",
        "first_name": "NICOLAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PR",
            "license": "10813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.