Individual provider Active NPI

Yania Nicolau, M.D.

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1659617967
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
18978 Issued in PR
Practice address
139 Carr 177
Apt 606
San Juan, PR 00926-5348
Phone
(787) 367-5057
NPI assigned
Dec 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 18978 PR Primary

Addresses

Primary practice location

139 Carr 177
Apt 606
San Juan, PR 00926-5348

Mailing address

139 Carr 177
Apt 606
San Juan, PR 00926-5348
Phone (787) 367-5057

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
I20190520000625 PR Practitioner - General Practice 5597008318 Reassigns benefits to 2 organizations
Practice locations: San Juan, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermgroup LLC Single Specialty CurrentSince Sep 24, 2021 Accepting new patients
Physician H.M.O. Inc. Single Specialty CurrentSince Oct 25, 2018 Accepting new patients

Locations

107 Calle Padre Las Casas
San Juan, PR 00918
Phone (787) 294-7801

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1659617967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CARR 177",
            "address_2": "APT 606",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265348",
            "telephone_number": "787-367-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CARR 177",
            "address_2": "APT 606",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265348",
            "telephone_number": "787-367-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAU",
        "first_name": "YANIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-14",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "18978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.