NPIMap

Organization Active NPI

Basic Medical Group

  • Family Medicine Physician
  • San Juan, PR
National Provider Identifier
1770536799
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6366 Issued in PR
Legal business name
BASIC MEDICAL GROUP
Practice address
402 Ave Munoz Rivera
San Juan, PR 00918-3310
Phone
(787) 754-8612
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Luz C Castellano
Title
President
Phone
(787) 273-1227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 6366 PR Primary

Addresses

Primary practice location

402 Ave Munoz Rivera
San Juan, PR 00918-3310

Mailing address

PO Box 191060
San Juan, PR 00919-1060

National Provider Directory

National Provider Directory
Tax ID family
Advancer Local Development3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770536799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191060",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009191060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 AVE MUNOZ RIVERA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183310",
            "telephone_number": "787-754-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASTELLANO",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-273-1227"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "6366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.