Individual provider Active NPI

Humberto Simonetti, M.D.

  • Internal Medicine Physician
  • Ponce, PR
National Provider Identifier
1619972635
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7884 Issued in PR
Practice address
Hospital San Lucas II Lobby
Ave Tito Castro Carr 14 Bo Machuelo
Ponce, PR 00731
Phone
(787) 844-2080
Fax
(787) 841-4832
NPI assigned
Jun 16, 2005
Reactivated
Mar 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7884 PR
Internal Medicine Physician 207R00000X 7884 PR Primary

Addresses

Primary practice location

Hospital San Lucas II Lobby
Ave Tito Castro Carr 14 Bo Machuelo
Ponce, PR 00731

Mailing address

P O Box 7437
Ponce, PUERTO RICO 00732-7437
UM
Phone (787) 259-7727

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
I20070817000501 PR Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5991897134 Practice locations: Ponce, PR

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
San Juan Bautista School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

909 Ave Tito Castro
Ponce, PR 00716-4721
Phone (787) 259-7727

Ave Tito Castro
909 Suite 517
Ponce, PR 00716-4721

Hospital & facility affiliations

  • Hospital Episcopal San Lucas II Hospital, Ponce, PR, CCN 400044

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Med del Sur, P.S.C. Specialist Past Accepting new patients
Asociacion Cardiovascular del Sur de Puerto Rico, Inc. Cardiovascular Disease PastSince Dec 18, 2016 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1619972635",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "P O BOX 7437",
            "city": "PONCE",
            "state": "PUERTO RICO",
            "postal_code": "007327437",
            "telephone_number": "17872597727",
            "fax_number": "17878414832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL SAN LUCAS II LOBBY",
            "address_2": "AVE TITO CASTRO CARR 14 BO MACHUELO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00731",
            "telephone_number": "787-844-2080",
            "fax_number": "787-841-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONETTI",
        "first_name": "HUMBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "7884",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "7884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.