Individual provider Active NPI

Norma E Agosto-Maury, MD

  • Clinical Neurophysiology Physician
  • San Juan, PR
National Provider Identifier
1679531206
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
4731 Issued in PR
Practice address
A2 Calle Lodi
Urb Villa Luarca
San Juan, PR 00924
Phone
(787) 751-5955
Fax
(787) 767-0516
NPI assigned
May 3, 2006
Last updated
Apr 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 4731 PR Primary

Addresses

Primary practice location

A2 Calle Lodi
Urb Villa Luarca
San Juan, PR 00924

Mailing address

A2 Calle Lodi
Urb Villa Luarca
San Juan, PR 00924
Phone (787) 751-5955

Other identifiers 3

IdentifierTypeStateIssuer
068347OtherBLUE CROSS
A174OtherIMC CIGNA CANADA LIFE TRI
601532OtherMMM CIGNA CANADA LIFE TRI

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
I20100907001061 PR Practitioner - NeurologyPractitioner - Internal MedicinePractitioner - Neuropsychiatry 6204950637 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Internal Medicine, Neuropsychiatry
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

A2 Calle Lodi
San Juan, PR 00924-3804
Phone (787) 751-5955

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4137PRMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Neurodiagnostico, Inc. Past Accepting new patients

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1679531206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "A2 CALLE LODI",
            "address_2": "URB VILLA LUARCA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00924",
            "telephone_number": "787-751-5955",
            "fax_number": "787-767-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A2 CALLE LODI",
            "address_2": "URB VILLA LUARCA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00924",
            "telephone_number": "787-751-5955",
            "fax_number": "787-767-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTO-MAURY",
        "first_name": "NORMA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "PR",
            "license": "4731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "068347",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMC CIGNA CANADA LIFE TRI",
            "identifier": "A174",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM CIGNA CANADA LIFE TRI",
            "identifier": "601532",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.