Idamaris Alicea, M.D.
Individual provider Active NPI General Practice Physician · Lares, PR
NPI 1609896281 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609896281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 16087 (PR)
- Practice address
- Carr. 111 KM 22.2
Lares, PR 00669 - Phone
- (787) 897-6802
- NPI assigned
- Jul 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centro de Salud de Lares Inc
Practice addresses (Care Compare)
PO Box
Suite 379
Lares, PR 00669-0379
Hospital & facility affiliations
- Emmanuel Hospice Care Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121212000379 | PR | Practitioner - General Practice | 4587816822 |
Reassigns benefits to 2 organizations Practice locations: Hatillo, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Salud de Lares, Inc. | Current |
Accepting new patients | |
| Centro de Salud de Lares, Inc | Current |
Accepting new patients | |
| Centro de Salud de Lares, Inc | Current |
Accepting new patients | |
| Emergency Physician Providers, LLC | Past | Accepting new patients | |
| Platinum Emergency Physicians, PSC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 16087 | PR | Yes |
Addresses
Primary practice location
Carr. 111 KM 22.2
Lares, PR 00669
Mailing address
PO Box 211
Lares, PR 00669-0211
Phone (787) 897-6802
Other providers in Lares, PR
- Andrea A Acevedo Villanueva
- Jorge Luis Acevedo
- Norma Iris Acevedo
- Ramon Acevedo
- Janeishka K Alicea Toledo
- Alma Enterprises Inc
- Rosita Zamary Alvarez
- Am Pediatrics PSC
- Sandra L Amador
- Amazing Ambulance Service, Inc.
All providers in Lares, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.