NPIMap

Organization Active NPI

Agosto Diabetes-Thyroid and Endocrinology CSP

  • Endocrinology, Diabetes & Metabolism Physician
  • Cayey, PR
National Provider Identifier
1780970178
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
15558 Issued in PR
Legal business name
AGOSTO DIABETES-THYROID AND ENDOCRINOLOGY CSP
Practice address
109 Ave Jose de Diego E
Cayey, PR 00736-3822
Phone
(787) 402-7693
Fax
(787) 905-7908
NPI assigned
Jun 23, 2011
Last updated
Aug 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Authorized official

Name
Dr. Marielba Agosto Mujica, M.D.
Title
President
Phone
(787) 402-7693

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 15558 PR
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 15558 PR Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 15151 PR

Addresses

Primary practice location

109 Ave Jose de Diego E
Cayey, PR 00736-3822

Mailing address

PO Box 6400
Cayey, PR 00737-6400
Phone (787) 402-7693

Other practice location 1

Carr #14 km 72.2
Suite # 308 Torre Medica
Cayey, PR 00736-4100
Phone (787) 635-4374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120130000740 PR Part B Supplier - Clinic/Group Practice 3072770254 Receives reassigned benefits from 2 practitioners
Practice locations: Cayey, PR

National Provider Directory

National Provider Directory

Locations

109 Ave Jose de Diego E
Cayey, PR 00736
Phone (787) 366-0634

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1780970178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6400",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "007376400",
            "telephone_number": "787-402-7693",
            "fax_number": "787-905-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 AVE JOSE DE DIEGO E",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "007363822",
            "telephone_number": "787-402-7693",
            "fax_number": "787-905-7908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Carr #14 km 72.2",
            "address_2": "Suite # 308 Torre Medica",
            "address_purpose": "LOCATION",
            "city": "Cayey",
            "state": "PR",
            "postal_code": "007364100",
            "country_code": "US",
            "telephone_number": "787-635-4374",
            "fax_number": "787-535-1139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AGOSTO DIABETES-THYROID AND ENDOCRINOLOGY CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-23",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "AGOSTO MUJICA",
        "authorized_official_first_name": "MARIELBA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-402-7693",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "15558",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PR",
            "license": "15558",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "15151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayey, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.