Carlos Antonio Izcoa, D.M.D.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

2244 Issued in PR

Practice address

B9 Calle Santa Cruz
Bayamon, PR 00961-6902

Phone

(787) 798-1772

Fax

(787) 288-5021

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1639206253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "D9 CALLE 1",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009616908",
            "telephone_number": "787-798-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B9 CALLE SANTA CRUZ",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009616902",
            "telephone_number": "787-798-1772",
            "fax_number": "787-288-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZCOA",
        "first_name": "CARLOS",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "PR",
            "license": "2244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthodontics in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Prosthodontics in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.

Verify at the official NPI Registry.