Individual provider Active NPI

Micheilisse Lopez Fraceschini, MD

  • General Practice Physician
  • Caguas, PR
National Provider Identifier
1639944952
Registry record updated Feb 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
24242 Issued in PR
Practice address
B14 Calle Daguao
Caguas, PR 00727-7732
Phone
(787) 981-6563
NPI assigned
Nov 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X 24242 PR Primary

Addresses

Primary practice location

B14 Calle Daguao
Caguas, PR 00727-7732

Mailing address

B14 Calle Daguao
Caguas, PR 00727-7732
Phone (787) 981-6563

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
I20260218002722 PR Practitioner - General Practice 2466932314 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1451 Ashford Ave Condado
San Juan, PR 00907-1511
Phone (787) 721-2160

Parque del Rio Calle Daguao
Suite 14
Caguas, PR 00727-7732

Urb Villa Lissette a-4 Calle Benitez
Guaynabo, PR 00969-3439

Hospital & facility affiliations

  • Presbyterian Community Hospital Hospital, San Juan, PR, CCN 400001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24242PRMDGeneral Practice Physician

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": "1700092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1639944952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "B14 CALLE DAGUAO",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007277732",
            "telephone_number": "787-981-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B14 CALLE DAGUAO",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007277732",
            "telephone_number": "787-981-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ FRACESCHINI",
        "first_name": "MICHEILISSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-16",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.