Individual provider Active NPI

Kyrmarie M Davila, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Mayaguez, PR
National Provider Identifier
1679854954
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
19912 Issued in PR
Practice address
Edificio la Palma
Calle Peral #14 Suite Ic
Mayaguez, PR 00677
Phone
(787) 644-2002
NPI assigned
Aug 31, 2011
Last updated
Jan 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19912 PR
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 19912 PR Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 19912 PR

Addresses

Primary practice location

Edificio la Palma
Calle Peral #14 Suite Ic
Mayaguez, PR 00677

Mailing address

PO Box 1431
Rincon, PR 00677-1431
Phone (787) 458-5858

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
I20180523000467 PR Practitioner - EndocrinologyPractitioner - Internal MedicinePractitioner - Geriatric Medicine 7719242759 Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Geriatric Medicine, Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Calle Peral Num 14
4F Edificio la Palma
Mayaguez, PR 00680
Phone (787) 644-2002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19912PRMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrinology Wellness Center LLC Endocrinology, Diabetes & Metabolism CurrentSince Jan 19, 2020 Accepting new patients
Dermatology and Mohs Surgery Associates LLC Past Accepting new patients

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, 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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1679854954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1431",
            "city": "RINCON",
            "state": "PR",
            "postal_code": "006771431",
            "telephone_number": "787-458-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDIFICIO LA PALMA",
            "address_2": "CALLE PERAL #14 SUITE IC",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00677",
            "telephone_number": "787-644-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "KYRMARIE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "19912",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PR",
            "license": "19912",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "PR",
            "license": "19912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.