Individual provider Active NPI

William Omar Marrero Ortiz, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • San Juan, PR
National Provider Identifier
1619418027
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
23096 Issued in PR
Practice address
735 Ave Ponce de Leon Ste 415
San Juan, PR 00917-5026
Phone
(787) 768-9813
NPI assigned
Mar 17, 2017
Last updated
May 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23096 PR
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 23096 PR Primary

Addresses

Primary practice location

735 Ave Ponce de Leon Ste 415
San Juan, PR 00917-5026

Mailing address

1509 Ave Ponce de Leon Apt 1173
San Juan, PR 00909-1796

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
I20230705002924 PR Practitioner - Geriatric Medicine 0143689471 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23096PRMDInternal Medicine Physician

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": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1619418027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 AVE PONCE DE LEON APT 1173",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009091796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON STE 415",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175026",
            "telephone_number": "787-768-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO ORTIZ",
        "first_name": "WILLIAM",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-17",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "23096",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "PR",
            "license": "23096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.