Dianne M Carrasquillo Bonila, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

19747 Issued in PR

Practice address

Centro Medico de Puerto Rico
Bo Monacillos Carr 22
Rio Piedras, PR 00976

Phone

(787) 765-7950

NPI assigned

May 18, 2016

Last updated

Jul 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Dermatology

Education

University of Puerto Rico School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dra. Dianne Carrasquillo L.L.C.

  • Dermatology Physician
  • San Juan, PR
  • NPI 1043986953

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1619324746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CALLE COSTA RICA CONDOMINIO GRANADA",
            "address_2": "APT 1B",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009174724",
            "telephone_number": "787-405-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRO MEDICO DE PUERTO RICO",
            "address_2": "BO MONACILLOS CARR 22",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-765-7950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4Q42 Calle 220",
            "address_purpose": "LOCATION",
            "city": "Trujillo Alto",
            "state": "PR",
            "postal_code": "009768228",
            "country_code": "US",
            "telephone_number": "787-405-1271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRASQUILLO BONILA",
        "first_name": "DIANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PR",
            "license": "19747",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Rio Piedras, PR
• Providers in Rio Piedras, PR by specialty
• Dermatology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.