Organization Active NPI

Emcara Health of Puerto Rico, LLC

  • Nurse Practitioner
  • San Juan, PR
National Provider Identifier
1649960022
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
EMCARA HEALTH OF PUERTO RICO, LLC
Practice address
450 Constitution Ave
Torre de la Reina Suite 200
San Juan, PR 00901
Phone
(800) 793-7050
NPI assigned
May 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Authorized official

Name
Jennifer Carriedo
Title
Credentialing & Contracting
Phone
(800) 793-7050

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X Primary
Adult Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LA2200X
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X
Gerontology Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LG0600X

Addresses

Primary practice location

450 Constitution Ave
Torre de la Reina Suite 200
San Juan, PR 00901

Mailing address

113 Seaboard LN Ste 200B
Franklin, TN 37067-8282
Phone (800) 793-7050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231005000014 PR Part B Supplier - Clinic/Group Practice 9436504875 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

450 Calle Constitucion
200
San Juan, PR 00920
Phone (800) 793-7050

450 Calle Constitucion
Ste 200
San Juan, PR 00920
Phone (800) 724-5850

450 Calle Constitucion
Ste 200
San Juan, PR 00920
Phone (800) 724-5850

450 Calle Constitucion
200
San Juan, PR 00920
Phone (800) 793-7050

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1649960022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 SEABOARD LN STE 200B",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370678282",
            "telephone_number": "800-793-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CONSTITUTION AVE",
            "address_2": "TORRE DE LA REINA SUITE 200",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00901",
            "telephone_number": "800-793-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMCARA HEALTH OF PUERTO RICO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "CARRIEDO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING & CONTRACTING",
        "authorized_official_telephone_number": "800-793-7050"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.