Individual provider Active NPI

Yimar Berrios-Diaz

  • Anesthesiology Physician
  • Guaynabo, PR
National Provider Identifier
1760795702
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
18554 Issued in PR
Practice address
Carr 165 KM 1.2 #48
City Plaza Suite 1010
Guaynabo, PR 00968
Phone
(787) 250-1708
Fax
(787) 758-9200
NPI assigned
Jul 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 257381-1 NY
Anesthesiology Physician 207L00000X 18554 PR Primary

Addresses

Primary practice location

Carr 165 KM 1.2 #48
City Plaza Suite 1010
Guaynabo, PR 00968

Mailing address

PO Box 366257
San Juan, PR 00936-6257
Phone (787) 250-1708

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
I20151229002052 PR Practitioner - Anesthesiology 1658540315 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
257381-1NYMDAnesthesiology Physician
18554PRMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grupo Anestesiologos de Ojos Anesthesiology CurrentSince Sep 2, 2024 Accepting new patients

Locations

352 Calle Angel Buonomo
San Juan, PR 00918
Phone (787) 722-2251

Organizations & group practices 1

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": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1760795702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366257",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009366257",
            "telephone_number": "787-250-1708",
            "fax_number": "787-758-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 165 KM 1.2 #48",
            "address_2": "CITY PLAZA SUITE 1010",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00968",
            "telephone_number": "787-250-1708",
            "fax_number": "787-758-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRIOS-DIAZ",
        "first_name": "YIMAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-20",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "257381-1",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PR",
            "license": "18554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.