Individual provider Active NPI

William Redondo Menicucci, MD

  • Cardiovascular Disease Physician
  • San Juan, PR
National Provider Identifier
1609362797
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
36930 Issued in PR
Practice address
University District Hospital Barrrio Monacillos
San Juan, PR 00935-0001
Phone
(787) 754-0101
NPI assigned
Jul 2, 2018
Last updated
May 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Cardiovascular Disease Physician 207RC0000X 36930 PR Primary

Addresses

Primary practice location

University District Hospital Barrrio Monacillos
San Juan, PR 00935-0001

Mailing address

PO Box 2116
San Juan, PR 00922-2116
Phone (787) 754-0101

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
I20260427003540 PR Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Geriatric Medicine 4587131552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Geriatric Medicine
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

600 Ave Jesus T Pinero
San Juan, PR 00918

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36930PRMDRegistered Nurse

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1609362797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2116",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009222116",
            "telephone_number": "787-754-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY DISTRICT HOSPITAL BARRRIO MONACILLOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-754-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDONDO MENICUCCI",
        "first_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PR",
            "license": "36930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.