Individual provider Active NPI

Elizabeth Maldonado, MS-A

  • Audiologist
  • Caguas, PR
National Provider Identifier
1790864874
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
257 Issued in PR
Practice address
PD Plaza Local 6
Ave. Jose Mercado 112
Caguas, PR 00725
Phone
(787) 469-3710
NPI assigned
Nov 2, 2006
Last updated
Oct 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 257 PR Primary

Addresses

Primary practice location

PD Plaza Local 6
Ave. Jose Mercado 112
Caguas, PR 00725

Mailing address

PMB 393200
Ave R. Cordero 140
Caguas, PR 00725
Phone (787) 469-3710

Other identifiers 1

IdentifierTypeStateIssuer
257OtherPRSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120329000181 PR Practitioner - Qualified Audiologist 0244490241 Practice locations: Caguas, PR

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

112 Ave Jose Mercado
PD Plaza Local 6
Caguas, PR 00725-3586
Phone (787) 469-3710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
257PRMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Montanez Therapy Group PastSince Jul 25, 2019 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1790864874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 393200",
            "address_2": "AVE R. CORDERO 140",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-469-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PD PLAZA LOCAL 6",
            "address_2": "AVE. JOSE MERCADO 112",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-469-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "ELIZABETH",
        "credential": "MS-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PR",
            "license": "257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "257",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.