Active NPI
Amanda Yadirah Ortiz Vicil
- Hepatology Physician
- Guayama, PR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hepatology Physician
- License
- 023723
- Practice address
- C16 Calle Azucena
Urb Green Hills
Guayama, PR 00784 - Phone
- (787) 214-3740
- NPI assigned
- Jun 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hepatology Physician | 207RI0008X | 023723 | PR | Primary |
Addresses
Primary practice location
C16 Calle Azucena
Urb Green Hills
Guayama, PR 00784
Mailing address
Calle Cesar Gonzalez Condominio Parque de Las Fuentes
Apt 2303
San Juan, PR 00918
Phone (787) 214-3740
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6164903 | Other | PR | LICENCE NUMBER |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
715 Ave Ponce de Leon
San Juan, PR 00917-5032
Phone (787) 758-2000
Hospital & facility affiliations
- Hospicio Luz Celeste
- Hospital Espanol Auxilio Mutuo San Pablo
- Hospital Universitario Dr Ruiz Arnau
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023723 | PR | MD | Hepatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. | Current | Accepting new patients | |
| Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. | Current | Accepting new patients | |
| Am Acquisition I, LLC | Past | Accepting new patients | |
| Departamento de Salud | Past | Accepting new patients |
Locations
715 Ave Ponce de Leon
San Juan, PR 00917
Phone 7877582000 ext. 3216
715 Ave Ponce de Leon
Stop 375
San Juan, PR 00917
Phone 7877582000 ext. 3216
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- San Juan, PR
- NPI 1487947214
-
- Rehabilitation Clinic/Center
- San Juan, PR
- NPI 1992369615
-
- General Acute Care Hospital
- Bayamon, PR
- NPI 1518732700
-
- General Acute Care Hospital
- Bayamon, PR
- NPI 1992724140
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bayamon, PR
- NPI 1518732700
-
- General Acute Care Hospital
- Bayamon, PR
- NPI 1992724140
-
- Community Based Hospice Care Agency
- Caguas, PR
- NPI 1659732618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1720648025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CALLE CESAR GONZALEZ CONDOMINIO PARQUE DE LAS FUENTES",
"address_2": "APT 2303",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00918",
"telephone_number": "787-214-3740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "C16 CALLE AZUCENA",
"address_2": "URB GREEN HILLS",
"city": "GUAYAMA",
"state": "PR",
"postal_code": "00784",
"telephone_number": "787-214-3740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ VICIL",
"first_name": "AMANDA",
"middle_name": "YADIRAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-18",
"last_updated": "2024-09-23",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0008X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hepatology",
"state": "PR",
"license": "023723",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENCE NUMBER",
"identifier": "6164903",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Guayama, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.