NPIMap

Individual provider Active NPI

Bogart R Esparza Razo, MD

  • Psychiatry Physician
  • Ponce, PR
National Provider Identifier
1679521645
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
11849 Issued in PR
Practice address
Urb Valle Verde Paseo Real #1014
Ste 1
Ponce, PR 00716-3500
Phone
(787) 284-0574
Fax
(787) 284-0574
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 11849 PR Primary

Addresses

Primary practice location

Urb Valle Verde Paseo Real #1014
Ste 1
Ponce, PR 00716-3500

Mailing address

PO Box 76
Ponce, PR 00715-0076
Phone (787) 284-0574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050908000848 PR Practitioner - Psychiatry 4385676584 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metrohealth Central Corporation Past Accepting new patients
MM Psychiatric Services LLC Past Accepting new patients
Ponce Conductual Past Accepting new patients
C & M Internal Medicine, PSC Past Accepting new patients
Aps Clinics of Puerto Rico, Inc. Psychiatry Past Accepting new patients
Yauco Healthcare Corporation Past Accepting new patients
Southwest Health Corp Past Accepting new patients

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1679521645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 76",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007150076",
            "telephone_number": "787-284-0574",
            "fax_number": "787-284-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB VALLE VERDE PASEO REAL #1014",
            "address_2": "STE 1",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007163500",
            "telephone_number": "787-284-0574",
            "fax_number": "787-284-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPARZA RAZO",
        "first_name": "BOGART",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "11849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.