Active NPI
Ildaly Maldonado Aviles, M.D.
- General Practice Physician
- Isabela, PR
National Provider Identifier
1669547717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 15571
- Practice address
- Carr 113 Esq Carr 474 KM 0 Barrio Coto
Isabela, PR 00662-0001 - Phone
- (787) 872-6200
- Fax
- (787) 872-6200
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 15571 | PR | Primary |
Addresses
Primary practice location
Carr 113 Esq Carr 474 KM 0 Barrio Coto
Isabela, PR 00662-0001
Mailing address
PO Box 2072
Isabela, PR 00662-2072
Phone (787) 872-6200
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050512000497 | PR | Practitioner - General Practice | 8224079926 | Practice locations: Isabela, PR |
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Carr 474 Esq Carr
113 Bo Coto
Isabela, PR 00662
Phone (787) 872-6200
PO Box
Suite 2072
Isabela, PR 00662
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15571 | PR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702252800000",
"number": "1669547717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2072",
"city": "ISABELA",
"state": "PR",
"postal_code": "006622072",
"telephone_number": "787-872-6200",
"fax_number": "787-872-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 113 ESQ CARR 474 KM 0 BARRIO COTO",
"city": "ISABELA",
"state": "PR",
"postal_code": "006620001",
"telephone_number": "787-872-6200",
"fax_number": "787-872-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO AVILES",
"first_name": "ILDALY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2023-12-11",
"certification_date": "2023-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "15571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Isabela, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.