Individual provider Active NPI

Edgar Soto Perez, MD

  • General Practice Physician
  • Lares, PR
National Provider Identifier
1710657085
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23090 Issued in PR
Practice address
Carr 129 KM 13.7
Lares, PR 00669-9715
Phone
(787) 382-1590
NPI assigned
Sep 17, 2021
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 240-P.A. PR
General Practice Physician 208D00000X 16035-I PR
General Practice Physician 208D00000X 23090 PR Primary

Addresses

Primary practice location

Carr 129 KM 13.7
Lares, PR 00669-9715

Mailing address

HC 2 Box 6580
Lares, PR 00669-9715
Phone (787) 382-1590

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
I20230516000574 PR Practitioner - General Practice 7517323603 Reassigns benefits to 2 organizations
Practice locations: Lares, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

64 2 Carr
Suite 135
Castaner, PR 00631
Phone (787) 829-5010

Carr 135 KM
5 Castaner
Lares, PR 00669-0001
Phone (787) 319-3905

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16035-IPRMDGeneral Practice Physician
23090PRMDGeneral Practice Physician
240-P.A.PRMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital General de Castaner Inc. General Practice CurrentSince Jun 6, 2023 Accepting new patients
Esp Medical Group LLC General Practice CurrentSince Mar 1, 2024 Accepting new patients
Hospital General de Castaner Inc CurrentSince Jun 6, 2023 Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1710657085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 2 BOX 6580",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006699715",
            "telephone_number": "787-382-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 129 KM 13.7",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006699715",
            "telephone_number": "787-382-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO PEREZ",
        "first_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-17",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "240-P.A.",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16035-I",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

Verify at the official NPI Registry.