Individual provider Active NPI

Carmelo Berrios, M.D.

  • Community Health Worker
  • Humacao, PR
National Provider Identifier
1699075085
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
ACN570 Issued in FL
Practice address
8 Calle Orion
Humacao, PR 00791-3917
Phone
(787) 438-6598
NPI assigned
Nov 1, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 18065 PR
Community Health Worker 172V00000X ACN-570 FL
Community Health Worker 172V00000X ACN570 FL Primary

Addresses

Primary practice location

8 Calle Orion
Humacao, PR 00791-3917

Mailing address

8567 Coral Way # 367
Miami, FL 33155
Phone (787) 438-6598

Other practice location 1

8567 Coral Way # 367
Miami, FL 33155-2335
Phone (787) 438-6598

Other identifiers 1

IdentifierTypeStateIssuer
1699075085MedicaidFL

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
I20130904000188 PR Practitioner - General Practice 6608019054 Practice locations: Caguas, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN-570FLMDCommunity Health Worker
ACN570FLMDCommunity Health Worker
18065PRMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Professionals, CSP Past Accepting new patients

Organizations & group practices 1

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": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699075085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8567 CORAL WAY # 367",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33155",
            "telephone_number": "787-438-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CALLE ORION",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007913917",
            "telephone_number": "787-438-6598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8567 Coral Way # 367",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331552335",
            "country_code": "US",
            "telephone_number": "787-438-6598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRIOS",
        "first_name": "CARMELO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "PR",
            "license": "18065",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "ACN-570",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "ACN570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699075085",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.