Active NPI
Santiago Emanuel Quiles Guzman, MD
- Pediatrics Physician
- Yabucoa, PR
National Provider Identifier
1619499530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 21943
- Practice address
- 41 Calle Cristobal Colon
Yabucoa, PR 00767-3324 - Phone
- (939) 458-0939
- NPI assigned
- Jul 12, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 33129-R | PR | |
| Pediatrics Physician | 208000000X | 21943 | PR | Primary |
Addresses
Primary practice location
41 Calle Cristobal Colon
Yabucoa, PR 00767-3324
Mailing address
Ave Jupiter 86C
Bda Sandin
Vega Baja, PR 00694
Phone (787) 366-7445
Other practice location 1
Barrio Monacillos Centro Medico Rio Piedras
San Juan, PR 00935-0001
Phone (787) 480-2710
Other practice location 2
16 Calle Saturnino Rodriguez
Yabucoa, PR 00767-3533
Phone (787) 366-7445
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 66-0964255 | Other | PR | IRS |
| 038041300 | Medicaid | PR |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33129-R | PR | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Q Pediatrics PR | Single Specialty | Current | Accepting new patients |
Locations
41 Calle Cristobal Colon
Yabucoa, PR 00767
Phone (787) 266-6313
Interoperability endpoints
- sjcsquiles@yourcarecommunity.org
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1619499530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "AVE JUPITER 86C",
"address_2": "BDA SANDIN",
"city": "VEGA BAJA",
"state": "PR",
"postal_code": "00694",
"telephone_number": "787-366-7445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 CALLE CRISTOBAL COLON",
"city": "YABUCOA",
"state": "PR",
"postal_code": "007673324",
"telephone_number": "939-458-0939"
}
],
"practiceLocations": [
{
"address_1": "Barrio Monacillos Centro Medico Rio Piedras",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "009350001",
"country_code": "US",
"telephone_number": "787-480-2710",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16 Calle Saturnino Rodriguez",
"address_purpose": "LOCATION",
"city": "Yabucoa",
"state": "PR",
"postal_code": "007673533",
"country_code": "US",
"telephone_number": "787-366-7445",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "QUILES GUZMAN",
"first_name": "SANTIAGO",
"middle_name": "EMANUEL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-12",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PR",
"license": "33129-R",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "PR",
"license": "21943",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IRS",
"identifier": "66-0964255",
"state": "PR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "038041300",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Yabucoa, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.