Organization Active NPI

La Cumbre Medical LLC

  • Primary Care Clinic/Center
  • San Juan, PR
National Provider Identifier
1710313986
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
14749 Issued in PR
Legal business name
LA CUMBRE MEDICAL LLC
Practice address
505 Emiliano Pol Avenue
San Juan, PR 00926
Phone
(787) 708-2222
Fax
(787) 720-7693
NPI assigned
Sep 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Authorized official

Name
Dr. Miguel A Paladines, MDNPI 1023081114
Title
Medical Director
Phone
(787) 708-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 14749 PR Primary

Addresses

Primary practice location

505 Emiliano Pol Avenue
San Juan, PR 00926

Mailing address

Carolina Shopp Ctr
PO Box 9512
Carolina, PR 00985-5672
Phone (787) 708-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140102000454 PR Part B Supplier - Clinic/Group Practice 8123256864 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, 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.

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379548800000",
    "number": "1710313986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAROLINA SHOPP CTR",
            "address_2": "PO BOX 9512",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855672",
            "telephone_number": "787-708-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 EMILIANO POL AVENUE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-708-2222",
            "fax_number": "787-720-7693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CUMBRE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-19",
        "last_updated": "2013-09-19",
        "status": "A",
        "authorized_official_last_name": "PALADINES",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "787-708-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PR",
            "license": "14749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.