Individual provider Active NPI

Maryknoll De la Paz, MD

  • Hematology & Oncology Physician
  • Ponce, PR
National Provider Identifier
1740414291
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
20224 Issued in PR
Practice address
2225 Ponce Byp Ste 607
Ponce, PR 00717-1379
Phone
(787) 284-4830
Fax
(787) 284-4814
NPI assigned
May 13, 2009
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 20224 PR Primary

Addresses

Primary practice location

2225 Ponce Byp Ste 607
Ponce, PR 00717-1379

Mailing address

30 Calle Fresa
San Juan, PR 00926-5106
Phone (787) 549-6651

Other names 1

  • Dr. Marynoll De la Paz Former name

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
I20130328000493 PR Practitioner - Internal Medicine 1850536517 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caribbean Cancer Care Services LLCGroup PAC ID 9032436878, 6 clinicians

Practice addresses (Care Compare)

10 Carr 149 Barrio Lomas
Juana Diaz, PR 00795-2329
Phone (787) 804-6626

1212 Calle Acacia
Suite 101
Ponce, PR 00716-2969
Phone (787) 284-4830

Calle Prolongacion 25 de Julio
Yauco, PR 00698-3508
Phone (787) 992-7209

Desvio Sur KM 0
Guayama, PR 00784-5707
Phone (787) 866-8808

PR 701 KM 0
Salinas, PR 00751-3216
Phone (787) 482-7266

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20224PRMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc CurrentSince Jan 14, 2013 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Jan 14, 2013 Accepting new patients
Caribbean Cancer Care PastSince Jul 16, 2018 Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

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, 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": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1740414291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CALLE FRESA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265106",
            "telephone_number": "787-549-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 PONCE BYP STE 607",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171379",
            "telephone_number": "787-284-4830",
            "fax_number": "787-284-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA PAZ",
        "first_name": "MARYKNOLL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PR",
            "license": "20224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYNOLL",
            "last_name": "DE LA PAZ",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.