Individual provider Active NPI

Evelyn Ramos Fresse, P. T.

  • Physical Therapist
  • Guaynabo, PR
National Provider Identifier
1578951570
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1335 Issued in PR
Practice address
50 Calle Brazil
Gardenville
Guaynabo, PR 00966-2033
Phone
(787) 782-2436
Fax
(787) 782-2430
NPI assigned
Dec 30, 2014
Last updated
Dec 30, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1335 PR Primary

Addresses

Primary practice location

50 Calle Brazil
Gardenville
Guaynabo, PR 00966-2033

Mailing address

50 Brasil St
Gardenville
Guaynabo, PR 00966-2037
Phone (787) 782-2436

Other identifiers 1

IdentifierTypeStateIssuer
4067762OtherPRDRIVERS LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1335PRMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
JS Sport Medicine, PSC CurrentSince Sep 30, 2015 Accepting new patients

Locations

576 Calle Cesar Gonzalez
Ste 504
San Juan, PR 00918
Phone (787) 306-2764

Organizations & group practices 1

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": "1419897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1578951570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BRASIL ST",
            "address_2": "GARDENVILLE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662037",
            "telephone_number": "787-782-2436",
            "fax_number": "787-782-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CALLE BRAZIL",
            "address_2": "GARDENVILLE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662033",
            "telephone_number": "787-782-2436",
            "fax_number": "787-782-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS FRESSE",
        "first_name": "EVELYN",
        "credential": "P. T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-30",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "1335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "4067762",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.