Individual provider Active NPI

Luis Daniel Carcorze Soto, M.D.

  • Surgery Physician
  • Mayaguez, PR
National Provider Identifier
1689807968
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
18625 Issued in PR
Practice address
Edif la Palma
Esq de Diego Suite 1C
Mayaguez, PR 00680-4861
Phone
(787) 986-7325
NPI assigned
Sep 2, 2009
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 18625 PR Primary

Addresses

Primary practice location

Edif la Palma
Esq de Diego Suite 1C
Mayaguez, PR 00680-4861

Mailing address

Urb Eugenio Maria de Hostos
2 Ave Los Maestros
Mayaguez, PR 00682
Phone (787) 951-7074

Other identifiers 1

IdentifierTypeStateIssuer
18625OtherPRLICENCIA MEDICO PUERTO RICO

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
I20140717001825 PR Practitioner - General Surgery 8426274093 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Puerto Rico School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Ave Los Maestros
Mayaguez, PR 00682

Urn Eugenio Maria de Hostos
2 Ave Los Maestros
Mayaguez, PR 00682

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
LCS Surgical Services PSC Surgery CurrentSince May 23, 2014 Accepting new patients
Centro de Curaciones San Peregrino Inc CurrentSince May 30, 2019 Accepting new patients
Hospital San Carlos Incorporado Surgery Past Accepting new patients
Metro Mayaguez Inc Past Accepting new patients

Locations

15 Calle Dr Basora N
Mayaguez, PR 00680
Phone (787) 342-6120

Organizations & group practices 4

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": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1689807968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB EUGENIO MARIA DE HOSTOS",
            "address_2": "2 AVE LOS MAESTROS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00682",
            "telephone_number": "787-951-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDIF LA PALMA",
            "address_2": "ESQ DE DIEGO SUITE 1C",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006804861",
            "telephone_number": "787-986-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARCORZE SOTO",
        "first_name": "LUIS",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PR",
            "license": "18625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA MEDICO PUERTO RICO",
            "identifier": "18625",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.