NPIMap

Organization Active NPI

Primary Physician Care PSC

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1689810699
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PRIMARY PHYSICIAN CARE PSC
Practice address
361 Calle Sgto Luis Medina
Ext Roosevelt
San Juan, PR 00918-3817
Phone
(787) 763-6432
Fax
(855) 304-1818
NPI assigned
Dec 22, 2008
Last updated
Jun 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Mrs. Aleida G Nieves
Title
President
Phone
(787) 614-5231

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

361 Calle Sgto Luis Medina
Ext Roosevelt
San Juan, PR 00918-3817

Mailing address

138 Ave Winston Churchill
PMB 659
San Juan, PR 00926-6013
Phone (787) 614-5231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110311000661 PR Part B Supplier - Clinic/Group Practice 5294917274 Receives reassigned benefits from 7 practitioners
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

361 Calle Sgto Luis Medina
San Juan, PR 00918
Phone (787) 614-5231

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1689810699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 AVE WINSTON CHURCHILL",
            "address_2": "PMB 659",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266013",
            "telephone_number": "787-614-5231",
            "fax_number": "855-304-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 CALLE SGTO LUIS MEDINA",
            "address_2": "EXT ROOSEVELT",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183817",
            "telephone_number": "787-763-6432",
            "fax_number": "855-304-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY PHYSICIAN CARE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "NIEVES",
        "authorized_official_first_name": "ALEIDA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-614-5231",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.