Wanda E Maymi-Burgos, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

PR10858 Issued in PR

Practice address

B11 Villa Carmen
Caguas, PR 00725-5414

Phone

(787) 745-1235

Fax

(787) 745-1235

NPI assigned

May 26, 2005

Reactivated

Mar 30, 2006

Last updated

Feb 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Intermed Primary Care

  • Primary Care Clinic/Center
  • Caguas, PR
  • NPI 1780632638
  NPD (past)

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

{
    "created_epoch": "1117065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1689677312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VILLA CARMEN B 11",
            "address_2": "BOX 5533",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00726",
            "telephone_number": "787-745-1235",
            "fax_number": "787-745-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B11 VILLA CARMEN",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007255414",
            "telephone_number": "787-745-1235",
            "fax_number": "787-745-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYMI-BURGOS",
        "first_name": "WANDA",
        "middle_name": "E",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-26",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "deactivation_date": "2006-03-30",
        "reactivation_date": "2006-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "PR10858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willie R Matos, M.D.
• Jorge R Matta Gonzalez, MD
• Marvin Matta Rivera, M.D
• Olga Waleska Mattei Reyes, MS PHL
• Natalia Maverakis Ramirez, MPH
• Carlos Alberto Maymi, PHARMACY TECHNICIAN
• MB Clinical Laboratories East Corp. (Laboratorio Clinico Villa Ana Caguas I)
• MB Clinical Laboratories East Corp. (Laboratorio Clinico Villa Ana Caguas III)
• MB Clinical Laboratories East Corp. (Laboratorio Clinico Tropical by Villa Ana)
• MB Clinical Laboratories East Corp. (Laboratorio Clinico Villa Ana)

• General Practice Physician in Caguas, PR
• Providers in Caguas, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.