Individual provider Active NPI

Gladys Jeannette Cordova, MD

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1679685275
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7306 Issued in PR
Practice address
Carretica 844 #1741 Purple Tree
San Juan, PR 00926
Phone
(787) 760-2940
NPI assigned
Aug 31, 2006
Last updated
Jan 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7306 PR Primary

Addresses

Primary practice location

Carretica 844 #1741 Purple Tree
San Juan, PR 00926

Mailing address

PO Box 21321
Upr Station
San Juan, PR 00931
Phone (787) 760-2940

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
I20040802001247 PR Practitioner - Internal Medicine 5698746956 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carr 21 Num 1785 Las Lomas
Hospital Metropolitano San Juan
San Juan, PR 00926-9998
Phone (787) 760-2940

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7306PRMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1679685275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21321",
            "address_2": "UPR STATION",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00931",
            "telephone_number": "787-760-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETICA 844 #1741 PURPLE TREE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-760-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "GLADYS",
        "middle_name": "JEANNETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "7306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.