Individual provider Active NPI

Marielys Otero Maldonado, M.D.

  • Infectious Disease Physician
  • Manati, PR
National Provider Identifier
1649420480
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
17281 Issued in PR
Practice address
245 Calle Monte Carlo
Urb. Monaco 3
Manati, PR 00674-6674
Phone
(787) 415-0680
NPI assigned
Sep 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 17281 PR Primary

Addresses

Primary practice location

245 Calle Monte Carlo
Urb. Monaco 3
Manati, PR 00674-6674

Mailing address

245 Calle Monte Carlo
Urb. Monaco 3
Manati, PR 00674-6674
Phone (787) 415-0680

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
I20120207000432 PR Practitioner - Infectious DiseasePractitioner - Internal Medicine 7618134438 Practice locations: Manati, PR

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

85 Calle Luna
Manati, PR 00674

Hosp Manati Medical Ctr
Manati, PR 00674
Phone (787) 467-1212

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17281PRMDInfectious Disease 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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1649420480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CALLE MONTE CARLO",
            "address_2": "URB. MONACO 3",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006746674",
            "telephone_number": "787-415-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CALLE MONTE CARLO",
            "address_2": "URB. MONACO 3",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006746674",
            "telephone_number": "787-415-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO MALDONADO",
        "first_name": "MARIELYS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PR",
            "license": "17281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.