Active NPI
Willie R Matos, M.D.
- General Practice Physician
- Caguas, PR
National Provider Identifier
1669675013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 5030
- Practice address
- 195 Calle Gautier Benitez
Caguas, PR 00725-5509 - Phone
- (787) 745-7455
- NPI assigned
- Jun 5, 2007
- Sex
- Male
- 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 | 5030 | PR | Primary |
Addresses
Primary practice location
195 Calle Gautier Benitez
Caguas, PR 00725-5509
Mailing address
PO Box 8128
Caguas, PR 00726-8128
Phone (787) 405-3071
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5030 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669675013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8128",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007268128",
"telephone_number": "787-405-3071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 CALLE GAUTIER BENITEZ",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007255509",
"telephone_number": "787-745-7455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATOS",
"first_name": "WILLIE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "5030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caguas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.