Individual provider Active NPI

Grisely Moro Acevedo, MD

  • General Practice Physician
  • Aguadilla, PR
National Provider Identifier
1699383679
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
21842 Issued in PR
Practice address
110 Rd KM 28.5 Bo. Aguacate
Aguadilla, PR 00603-9442
Phone
(787) 223-0153
NPI assigned
Jul 16, 2020
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 21842 PR Primary

Addresses

Primary practice location

110 Rd KM 28.5 Bo. Aguacate
Aguadilla, PR 00603-9442

Mailing address

110 Rd KM 28.5 Bo. Aguacate
Aguadilla, PR 00603-9442
Phone (787) 223-0153

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
I20201112000857 PR Practitioner - General Practice 6800206376 Reassigns benefits to 1 organization
Practice locations: Aguadilla, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carr 107 KM
Aguadilla, PR 00603
Phone (787) 223-0153

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grymar Primary Care Services LLC General Practice CurrentSince Sep 1, 2023 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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1699383679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 RD KM 28.5 BO. AGUACATE",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006039442",
            "telephone_number": "787-223-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 RD KM 28.5 BO. AGUACATE",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006039442",
            "telephone_number": "787-223-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORO ACEVEDO",
        "first_name": "GRISELY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguadilla, PR

Sources for this page

Verify at the official NPI Registry.