Individual provider Active NPI

Miriam Matos-Matos, M.D.

  • Obstetrics & Gynecology Physician
  • San Juan, PR
National Provider Identifier
1710238977
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
11390 Issued in PR
Practice address
6 Calle San Carlos
Urb. Mansiones de Caldas
San Juan, PR 00926-5330
Phone
(787) 315-5190
NPI assigned
Sep 27, 2012
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 11390 PR Primary

Addresses

Primary practice location

6 Calle San Carlos
Urb. Mansiones de Caldas
San Juan, PR 00926-5330

Mailing address

6 Calle San Carlos
Urb. Mansiones de Caldas
San Juan, PR 00926-5330
Phone (787) 315-5190

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
I20160715000317 PR Practitioner - Obstetrics/Gynecology 7315239118 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11390PRMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Cancer de la Universidad CurrentSince Mar 15, 2022 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": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1710238977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CALLE SAN CARLOS",
            "address_2": "URB. MANSIONES DE CALDAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265330",
            "telephone_number": "787-315-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CALLE SAN CARLOS",
            "address_2": "URB. MANSIONES DE CALDAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265330",
            "telephone_number": "787-315-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS-MATOS",
        "first_name": "MIRIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PR",
            "license": "11390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.