Organization Active NPI

Belladonna Medical Wellness Inc.

  • Specialist
  • Bayamon, PR
National Provider Identifier
1689923807
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
13943 Issued in PR
Legal business name
BELLADONNA MEDICAL WELLNESS INC.
Practice address
Carr# 2 Esq. Betances Shopping Capri
Bayamon, PR 00961
Phone
(787) 449-8806
NPI assigned
Sep 4, 2012
Last updated
Dec 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Authorized official

Name
Dr. Evelyn Cintron, M.D.
Title
President
Phone
(787) 996-7520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 13943 PR Primary

Addresses

Primary practice location

Carr# 2 Esq. Betances Shopping Capri
Bayamon, PR 00961

Mailing address

Carr #2 Esq. Betances Shopping Capri
Bayamon, PR 00959

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161129000801 PR Part B Supplier - Clinic/Group Practice 1355621863 Receives reassigned benefits from 1 practitioner
Practice locations: Bayamon, PR; Vega Baja, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1689923807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CARR #2 ESQ. BETANCES SHOPPING CAPRI",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR# 2 ESQ. BETANCES SHOPPING CAPRI",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-449-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLADONNA MEDICAL WELLNESS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-04",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "CINTRON",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-996-7520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "13943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.