Individual provider Active NPI

Aleida G Nieves Martinez, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1598715310
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14546 Issued in PR
Practice address
Sgto. Luis Medina 361 Ext. Roosevelt
San Juan, PR 00918
Phone
(787) 763-6432
NPI assigned
May 11, 2006
Last updated
Jun 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 14546 PR Primary

Addresses

Primary practice location

Sgto. Luis Medina 361 Ext. Roosevelt
San Juan, PR 00918

Mailing address

138 Winston Churchill Ave.
PMB 659
San Juan, PR 00926
Phone (787) 763-6432

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
I20070316000156 PR Practitioner - General Practice 2264535988 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14546PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grupo Medico San Juan Health Centre General Practice Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aleida.nieves.1@30885.direct.athenahealth.com

Organizations & group practices 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1598715310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 WINSTON CHURCHILL AVE.",
            "address_2": "PMB 659",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-763-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SGTO. LUIS MEDINA 361 EXT. ROOSEVELT",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-763-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES MARTINEZ",
        "first_name": "ALEIDA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.