Organization Active NPI

Antilles Foot Clinic

  • Foot & Ankle Surgery Podiatrist
  • San Juan, PR
National Provider Identifier
1558663146
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ANTILLES FOOT CLINIC
Practice address
1229 Ave Jesus T Pineiro
San Juan, PR 00920-5502
Phone
(787) 783-6650
Fax
(787) 783-5578
NPI assigned
Dec 2, 2010
Last updated
Dec 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Authorized official

Name
Dr. Roberto Sanchez Cordova, M.D.NPI 1174622096
Title
President
Phone
(787) 783-6650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PR Primary

Addresses

Primary practice location

1229 Ave Jesus T Pineiro
San Juan, PR 00920-5502

Mailing address

PO Box 366987
San Juan, PR 00936-6987
Phone (787) 783-6650

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110118001003 PR Part B Supplier - Clinic/Group Practice 4789873035 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

544 Ave Escorial
San Juan, PR 00920
Phone (787) 783-5578

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1558663146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366987",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009366987",
            "telephone_number": "787-783-6650",
            "fax_number": "787-783-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 AVE JESUS T PINEIRO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009205502",
            "telephone_number": "787-783-6650",
            "fax_number": "787-783-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTILLES FOOT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ CORDOVA",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-783-6650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PR",
            "license": null,
            "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 Dec 2, 2010; 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.