Individual provider Active NPI

Felipe Jose Fraticelli

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1679232862
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23172 Issued in PR
Practice address
Centro Medico de Puerto Rico Barrio Monacillos
San Juan, PR 00935-0001
Phone
(787) 777-3535
NPI assigned
Dec 15, 2021
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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 23172 PR Primary

Addresses

Primary practice location

Centro Medico de Puerto Rico Barrio Monacillos
San Juan, PR 00935-0001

Mailing address

H10 Via Cumbres
San Juan, PR 00924-4474
Phone (787) 565-1824

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
I20230905001434 PR Practitioner - General Practice 8224491352 Reassigns benefits to 1 organization
Practice locations: Rio Piedras, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23172PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dzeus Corp. General Practice CurrentSince Aug 19, 2025 Accepting new patients

Locations

7508 Ave Sfc Agustin Ramos Calero
Isabela, PR 00662
Phone (787) 333-0770

Organizations & group practices 1

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": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1679232862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "H10 VIA CUMBRES",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009244474",
            "telephone_number": "787-565-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRO MEDICO DE PUERTO RICO BARRIO MONACILLOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-777-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRATICELLI",
        "first_name": "FELIPE",
        "middle_name": "JOSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-15",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.