Individual provider Active NPI

Priscilla Magno, M.D.

  • Gastroenterology Physician
  • San Juan, PR
National Provider Identifier
1679675144
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
14740 Issued in PR
Practice address
Carr #18 Int 21
Bo. Monacillo
San Juan, PR 00927
Phone
(787) 936-1477
Fax
(787) 936-1491
NPI assigned
Sep 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X D0065053 MD
Gastroenterology Physician 207RG0100X 14740 PR Primary

Addresses

Primary practice location

Carr #18 Int 21
Bo. Monacillo
San Juan, PR 00927

Mailing address

101 Calle Jazmin
San Juan, PR 00927-6312
Phone (787) 344-3775

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
I20071109000283 PR Practitioner - GastroenterologyPractitioner - Internal Medicine 7911905807 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14740PRMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Hato Rey Inc CurrentSince Jul 1, 2023 Accepting new patients
Women's Pelvic Health and Reconstructive Surgery LLC PastSince Apr 1, 2021 Accepting new patients

Locations

435 Ave Ponce de Leon
San Juan, PR 00917
Phone (787) 616-3459

Organizations & group practices 2

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": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1679675144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CALLE JAZMIN",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009276312",
            "telephone_number": "787-344-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #18 INT 21",
            "address_2": "BO. MONACILLO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00927",
            "telephone_number": "787-936-1477",
            "fax_number": "787-936-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNO",
        "first_name": "PRISCILLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-03",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D0065053",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "14740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.