Individual provider Active NPI

Pablo Mojica Manosa, MD

  • Surgical Oncology Physician
  • San Juan, PR
National Provider Identifier
1679632756
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
A90780 Issued in CA
Practice address
208 Ave Ponce de Leon # 715
Parada 37
San Juan, PR 00918-1000
Phone
(787) 771-7933
NPI assigned
Dec 6, 2006
Last updated
Jul 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X A90780 CA Primary

Addresses

Primary practice location

208 Ave Ponce de Leon # 715
Parada 37
San Juan, PR 00918-1000

Mailing address

362 Camino de Los Laureles
Sabanera del Rio
Gurabo, PR 00778-5250
Phone (787) 744-2052

Other identifiers 1

IdentifierTypeStateIssuer
00A907800MedicaidCA

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
I20070919000489 PR Practitioner - Surgical OncologyPractitioner - General Practice 8123057643 Reassigns benefits to 1 organization
Practice locations: Hato Rey, PR

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Practice
Education
University of Puerto Rico School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

PR 21 Int PR
18 Bo. Monacillos Urbano
San Juan, PR 00927
Phone 78777283005302

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14377PRMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Cancer de la Universidad Surgery CurrentSince Feb 20, 2021 Accepting new patients
Centro de Cancer de la Universidad Past Accepting new patients
California Cancer Specialists Medical Group Inc Surgery Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pablo.mojicamanosa@auxiliomutuo.ikm.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1679632756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 CAMINO DE LOS LAURELES",
            "address_2": "SABANERA DEL RIO",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007785250",
            "telephone_number": "787-744-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 AVE PONCE DE LEON # 715",
            "address_2": "PARADA 37",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009181000",
            "telephone_number": "787-771-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJICA MANOSA",
        "first_name": "PABLO",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "A90780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A907800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.