Organization Active NPI

Embata Corp.

  • Specialist
  • Carolina, PR
National Provider Identifier
1629405287
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
13819 Issued in PR
Legal business name
EMBATA CORP.
Practice address
6410 Ave Isla Verde Apt 4 L Este
Carolina, PR 00979
Phone
(787) 373-9664
NPI assigned
Sep 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Authorized official

Name
Miguel Juan Goyechea, M.D.
Title
President
Phone
787373966466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 13819 PR Primary

Addresses

Primary practice location

6410 Ave Isla Verde Apt 4 L Este
Carolina, PR 00979

Mailing address

J 6 Calle 2 Urb. Brisas del Mar
Luquillo, PR 00773
Phone (787) 355-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210426002856 PR Part B Supplier - Clinic/Group Practice 2264840529 Receives reassigned benefits from 1 practitioner
Practice locations: Luiquillo, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1629405287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "J 6 CALLE 2 URB. BRISAS DEL MAR",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "00773",
            "telephone_number": "787-355-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 AVE ISLA VERDE APT 4 L ESTE",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00979",
            "telephone_number": "787-373-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBATA CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "GOYECHEA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "JUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787373966466",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "13819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.