Individual provider Active NPI

Kisha Christina Brunet Fuentes, M.D.

  • Pediatrics Physician
  • San Juan, PR
National Provider Identifier
1578864294
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
18510 Issued in PR
Practice address
1394 Calle San Lucas
Alta Mesa
San Juan, PR 00921-4316
Phone
(787) 662-6439
NPI assigned
Nov 11, 2010
Last updated
May 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 18510 PR Primary

Addresses

Primary practice location

1394 Calle San Lucas
Alta Mesa
San Juan, PR 00921-4316

Mailing address

Calle San Lucas 1394
Alta Mesa
San Juan, PR 00921-4316
Phone (787) 662-6439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18510PRMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Jorge Children's Hospital, Inc. Past Accepting new patients
Puerto Rico Women and Children S Hospital LLC Past Accepting new patients
The San Jorge Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sjckbrunet@yourcarecommunity.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1578864294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE SAN LUCAS 1394",
            "address_2": "ALTA MESA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009214316",
            "telephone_number": "787-662-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1394 CALLE SAN LUCAS",
            "address_2": "ALTA MESA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009214316",
            "telephone_number": "787-662-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNET FUENTES",
        "first_name": "KISHA",
        "middle_name": "CHRISTINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-11",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "18510",
            "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 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.