Individual provider Active NPI

Itza Doris Chevres, M.D.

  • General Practice Physician
  • Toa Alta, PR
National Provider Identifier
1669413720
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9462 Issued in PR
Practice address
Calle 10 Carr.165 Esq. G-21 Urb. Villa Matilde
Toa Alta, PR 00953-0000
Phone
(787) 870-7000
Fax
(787) 870-6382
NPI assigned
Jun 9, 2006
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 9462 PR Primary

Addresses

Primary practice location

Calle 10 Carr.165 Esq. G-21 Urb. Villa Matilde
Toa Alta, PR 00953-0000

Mailing address

143 Calle Cedro
Urb. Hacienda Mi Querido Viejo
Dorado, PR 00646-2608
Phone (939) 645-0504

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
I20131009000894 PR Practitioner - General Practice 5395749816 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Clinic of Caribbean, Inc General Practice CurrentSince Sep 7, 2016 Accepting new patients
Centro Imagenes Radiologia Toa Alta CurrentSince Mar 17, 2014 Accepting new patients
Toa Alta Family Clinic LLC General Practice PastSince Jun 1, 2019 Accepting new patients

Locations

G21 Calle 10
Toa Alta, PR 00953
Phone (787) 870-7070

Organizations & group practices 6

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1669413720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 CALLE CEDRO",
            "address_2": "URB. HACIENDA MI QUERIDO VIEJO",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006462608",
            "telephone_number": "939-645-0504",
            "fax_number": "787-870-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 10 CARR.165 ESQ. G-21 URB. VILLA MATILDE",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009530000",
            "telephone_number": "787-870-7000",
            "fax_number": "787-870-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEVRES",
        "first_name": "ITZA",
        "middle_name": "DORIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Alta, PR

Sources for this page

Verify at the official NPI Registry.