Ivemilia Pedraza

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

14463 Issued in PR

Practice address

99 Guillermo Riefkhol St.
Patillas, PR 00723

Phone

(787) 839-4320

Fax

(787) 271-0004

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ivemilia.pedraza@cspsp.directbygreenway.com

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.

• Centro Servicios Primarios de Salud de Patillas Inc.

  • Federally Qualified Health Center (FQHC)
  • Patillas, PR
  • NPI 1275539728
  Medicare reassignment NPD
• Centro de Servicios Primarios de Salud de Patillas Inc.

  • Health Service Clinic/Center
  • Salinas, PR
  • NPI 1154070365
  NPD
• Centro Servicios Primarios de Salud de Patillas Inc.

  • Land Ambulance
  • Patillas, PR
  • NPI 1164532792
  NPD (past)
• Centro Servicios Primarios de Salud de Patillas Inc.

  • Radiology Clinic/Center
  • Patillas, PR
  • NPI 1366654337
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1790843027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 697",
            "city": "PATILLAS",
            "state": "PR",
            "postal_code": "00723",
            "telephone_number": "787-839-4320",
            "fax_number": "787-271-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 GUILLERMO RIEFKHOL ST.",
            "city": "PATILLAS",
            "state": "PR",
            "postal_code": "00723",
            "telephone_number": "787-839-4320",
            "fax_number": "787-271-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRAZA",
        "first_name": "IVEMILIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariely Nicole Ortiz, DMD
• Ruth Ortiz, RN
• Wanda Ortiz, PHARMACY TECHNICIAN
• Mirta Pabon, MSW
• Patillas X-Ray
• Luis A Pena Molina
• Gabriel J Perez Martinez, ENFERMERO
• Pro Salud Express, Inc.
• Jean Carlos Quinones Rivera, RN
• Gretchen Marie Ramirez Millan

• General Practice Physician in Patillas, PR
• Providers in Patillas, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.