NPIMap

Organization Active NPI

Critical Care Medicine Services, Inc.

  • Critical Care Medicine (Internal Medicine) Physician
  • San Juan, PR
National Provider Identifier
1669470514
Registry record updated Oct 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
7355 Issued in PR
Legal business name
CRITICAL CARE MEDICINE SERVICES, INC.
Practice address
1276 Calle 54 SE
Urb. la Riviera
San Juan, PR 00921-3141
Phone
(787) 381-0247
Fax
(787) 755-9005
NPI assigned
Jul 13, 2005
Last updated
Oct 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2009

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

Authorized official

Name
Dr. Jorge Paoli-Bruno, M.D.NPI 1982601159
Title
Medical Director
Phone
(787) 381-0247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 12292 PR
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 7355 PR Primary

Addresses

Primary practice location

1276 Calle 54 SE
Urb. la Riviera
San Juan, PR 00921-3141

Mailing address

PO Box 193789
San Juan, PR 00919-3789
Phone (787) 381-0247

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000225 PR Part B Supplier - Clinic/Group Practice 0749178036 Receives reassigned benefits from 1 practitioner
Practice locations: Caguas, PR; Fajardo, PR; Humacao, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255910400000",
    "number": "1669470514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193789",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009193789",
            "telephone_number": "787-381-0247",
            "fax_number": "787-755-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 CALLE 54 SE",
            "address_2": "URB. LA RIVIERA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213141",
            "telephone_number": "787-381-0247",
            "fax_number": "787-755-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRITICAL CARE MEDICINE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2009-10-19",
        "status": "A",
        "authorized_official_last_name": "PAOLI-BRUNO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "787-381-0247",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PR",
            "license": "12292",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PR",
            "license": "7355",
            "primary": true
        }
    ],
    "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 Oct 19, 2009; 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.