Medical Family Practice Ctr CSP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12748 Issued in PR

Legal business name

MEDICAL FAMILY PRACTICE CTR CSP

Practice address

G5 Calle Marginal
Urb Vista Azul
Arecibo, PR 00612-2546

Phone

(787) 817-0573

Fax

(787) 816-0219

NPI assigned

Jul 30, 2006

Last updated

Sep 26, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Juan R Martino, M.D.NPI 1912914391

Title

President

Phone

(787) 817-0573

Specialties & licenses 1

Addresses

Other identifiers 15

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

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.

• Juan R Martino, M.D.

  • Family Medicine Physician
  • Arecibo, PR
  • NPI 1912914391
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348617600000",
    "number": "1700891439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 142529",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006142529",
            "telephone_number": "787-817-0573",
            "fax_number": "787-816-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G5 CALLE MARGINAL",
            "address_2": "URB VISTA AZUL",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006122546",
            "telephone_number": "787-817-0573",
            "fax_number": "787-816-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FAMILY PRACTICE CTR CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2012-09-26",
        "status": "A",
        "authorized_official_last_name": "MARTINO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-817-0573",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "12748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPVA",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMPR",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "84396",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAPFRE MEDICARE EXCEL",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AARP",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLOBAL HEALTH PLAN",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCS CLASSICARE",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM HEALTHCARE",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAPFRE",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCS",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMC",
            "identifier": "1700891439",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "DU442A",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHM",
            "identifier": "16098",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Mazucca, RN
• MC Medical Billing (Melissa Cintron)
• John Anthony McGowan
• Medic Medical Transport Inc
• Medic Services & Rentals
• Medical Services Group PSP
• Medicina Fisica Y Rehabilitacion del Norte, Inc.
• Medicina Integral 2010
• Luis Alberto Medina Aviles, MD
• Lekeshia Kristina Medina Cortez

• Family Medicine Physician in Arecibo, PR
• Providers in Arecibo, PR by specialty
• Family Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.