Individual provider Active NPI

Stephanie Marie Segura-Abreu, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1669095543
Registry record updated Jul 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22673 Issued in PR
Practice address
Calle Sergio Cuevas Bustamante #550, Hato Rey
San Juan, PR 00927
Phone
(787) 758-8383
NPI assigned
May 26, 2020
Last updated
Jul 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2022

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 NU
General Practice Physician 208D00000X 22673 PR Primary

Addresses

Primary practice location

Calle Sergio Cuevas Bustamante #550, Hato Rey
San Juan, PR 00927

Mailing address

Urb. Mountain View
Calle 58, C-25
Carolina, PR 00987

Other names 1

  • Stephanie Segura Professional name

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
I20220720003264 PR Practitioner - General Practice 9335520410 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22673PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656892800000",
    "number": "1669095543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. MOUNTAIN VIEW",
            "address_2": "CALLE 58, C-25",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SERGIO CUEVAS BUSTAMANTE #550, HATO REY",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00927",
            "telephone_number": "787-758-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGURA-ABREU",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2022-07-04",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SEGURA",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.