Individual provider Active NPI

Manuel A Colon, MD, RDMS, FAAEM

  • Emergency Medicine Physician
  • Carolina, PR
National Provider Identifier
1649246117
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
14590 Issued in PR
Practice address
65TH Infantry Ave. #3 St. KM 8.3
Carolina, PR 00985
Phone
(787) 757-1800
Fax
(787) 750-0930
NPI assigned
Feb 24, 2006
Last updated
Jan 25, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 14590 PR Primary

Addresses

Primary practice location

65TH Infantry Ave. #3 St. KM 8.3
Carolina, PR 00985

Mailing address

160 Camino Los Corozos
Urb. Sabanera del Rio
Gurabo, PR 00778
Phone (787) 564-8962

Other identifiers 1

IdentifierTypeStateIssuer
23672OtherPRSSS PROVIDER NUMBER

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
I20060331000080 PR Practitioner - Emergency Medicine 6507757911 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas CurrentSince Oct 19, 2010 Accepting new patients
Recinto de Ciencias Medicas Emergency Medicine CurrentSince Oct 19, 2010 Accepting new patients
St Lukes Roosevelt Hospital Center Emergency Medicine Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1649246117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 CAMINO LOS COROZOS",
            "address_2": "URB. SABANERA DEL RIO",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-564-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65TH INFANTRY AVE. #3 ST. KM 8.3",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-757-1800",
            "fax_number": "787-750-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "MANUEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD, RDMS, FAAEM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "14590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS PROVIDER NUMBER",
            "identifier": "23672",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.