Angel Luis Medina Orta

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

22601 Issued in PR

Practice address

Urb Santa Clara Calle 5 #222
San Lorenzo, PR 00754-9998

Phone

(787) 672-8753

NPI assigned

Feb 17, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• MF Dynamic Billing Corp

  • Health Information Specialist/Technologist
  • San Lorenzo, PR
  • NPI 1417564741
  NPD

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1720733710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB SANTA CLARA CALLE 5 #222",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "007549998",
            "telephone_number": "787-672-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB SANTA CLARA CALLE 5 #222",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "007549998",
            "telephone_number": "787-672-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA ORTA",
        "first_name": "ANGEL",
        "middle_name": "LUIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "22601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayra Maldonado, M.D.
• Moraida Martinez Morales
• Jose J Martinez Santana, M.D.
• Medical Transport Ambulance Inc
• Ernesto Medina de Jesus, MD
• Raphael Melendez, P.T.
• MF Dynamic Billing Corp
• Ruvva Milian, NL, CNC
• Fernando R Miranda-Ramirez, D.M.D.
• MMR Supermarket Inc

• General Practice Physician in San Lorenzo, PR
• Providers in San Lorenzo, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.