Edna Mercedes Castaneda Torres, MD
Individual provider Active NPI General Practice Physician · San Juan, PR
NPI 1639740749 · NPPES record last updated Jul 12, 2021
Key facts
- NPI
- 1639740749
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 22374 (PR)
- Practice address
- Centro Medico de Puerto Rico Barrio Monacillos
San Juan, PR 00935-0001 - Phone
- (787) 307-6693
- NPI assigned
- Jul 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230809003916 | PR | Practitioner - General Practice | 2466814314 |
Reassigns benefits to 1 organization Practice locations: San Juan, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22374 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatrix Medical Group of Puerto Rico, P.S.C | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 22374 | PR | Yes |
Addresses
Primary practice location
Centro Medico de Puerto Rico Barrio Monacillos
San Juan, PR 00935-0001
Mailing address
PO Box 649
San German, PR 00683-0649
Phone (787) 307-6693
Other practice location 1
Carretera 102
URB. Reparto Lomas Lindas #7 INT
San German, PR 00683
Phone (787) 307-6693
Other providers in San Juan, PR
- Angel David Sem Casillas Carmona
- Frances Enid Casillas Chiesa
- Casillas Psychological Services LLC
- Angel Emmanuel Casillas Rodriguez
- Franchard Casimir
- Castaner & Pou LLC
- Juan Castaner
- Aileen Castellano
- Jose Luis Castellano
- Isabel Castellanos Castillo
All providers in San Juan, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.