Individual provider Active NPI

Adolfo Lopez Mieres, MD

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1629062609
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13883 Issued in PR
Practice address
San Juan City Hospital
Medical Center
San Juan, PR 00911
Phone
(787) 765-5147
NPI assigned
Sep 7, 2005
Last updated
Aug 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 13883 PR
Internal Medicine Physician 207R00000X 13883 PR Primary

Addresses

Primary practice location

San Juan City Hospital
Medical Center
San Juan, PR 00911

Mailing address

Cond Camelot
Apt 4302 Carr 842
San Juan, PR 00926-9760
Phone (787) 429-9211

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
I20090129000340 PR Practitioner - Internal Medicine 1850455213 Reassigns benefits to 2 organizations
Practice locations: Rio Piedras, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Administracion de Servicios Medicos de Puerto RicoGroup PAC ID 4385715671, 6 clinicians

Practice addresses (Care Compare)

Edificio Central Julio a Perez
Bo Monacillo Carretera 22
San Juan, PR 00922
Phone (787) 777-3535

Hospital & facility affiliations

  • Asem Hospital, San Juan, PR, CCN 400127

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13883PRMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas Internal Medicine CurrentSince Jun 20, 2019 Accepting new patients
Recinto de Ciencias Medicas CurrentSince Jun 20, 2019 Accepting new patients
Administracion de Servicios Medicos de Puerto Rico CurrentSince Nov 23, 2022 Accepting new patients

Locations

BO Monacillos Centro Medico De Puerto Rico
San Juan, PR 00935
Phone (781) 763-4149

BO Monacillos Ctro Medico
San Juan, PR 00935

Organizations & group practices 3

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.

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1629062609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND CAMELOT",
            "address_2": "APT 4302 CARR 842",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009269760",
            "telephone_number": "787-429-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAN JUAN CITY HOSPITAL",
            "address_2": "MEDICAL CENTER",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00911",
            "telephone_number": "787-765-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ MIERES",
        "first_name": "ADOLFO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "13883",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "13883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.