Individual provider Active NPI

Kalopher I Sandoval Lugo

  • Internal Medicine Physician
  • Ponce, PR
National Provider Identifier
1750240107
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
24759 Issued in PR
Practice address
Hospital Episcopal San Lucas 917 Tito Castro Avenue
Ponce, PR 00733
Phone
(787) 844-2080
NPI assigned
Jan 21, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 24759 PR Primary

Addresses

Primary practice location

Hospital Episcopal San Lucas 917 Tito Castro Avenue
Ponce, PR 00733

Mailing address

539 Calle Diamante
San Sebastian, PR 00685-2745

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
I20260330000958 PR Practitioner - General Practice 0840775763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

Calle Jose Mendez Cardona
Suite 3
San Sebastian, PR 00685

Calle Jose Mendez Cardona
Suite 3
San Sebastian, PR 00685-0486

HC 4 Box
San Sebastian, PR 00685

PO Box
Quebradillas, PR 00678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24759PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Radiologico Shalom Inc CurrentSince Mar 10, 2026 Accepting new patients
Policlinica Familiar Shalom Inc PastSince Mar 10, 2026 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1750240107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 CALLE DIAMANTE",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006852745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL EPISCOPAL SAN LUCAS 917 TITO CASTRO AVENUE",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00733",
            "telephone_number": "787-844-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL LUGO",
        "first_name": "KALOPHER",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "24759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.