Kermit Colon-Quetlas, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5332 Issued in PR

Practice address

Calle Sta Cruz Num. 70
Urb Santa Cruz
Bayamon, PR 00960-0000

Phone

(787) 620-4747

Fax

(787) 620-9409

NPI assigned

Apr 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kermit Colon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790902591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB PARK GARDENS N-43",
            "address_2": "CALLE ACADIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009262123",
            "telephone_number": "787-761-8755",
            "fax_number": "787-761-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE STA CRUZ NUM. 70",
            "address_2": "URB SANTA CRUZ",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009600000",
            "telephone_number": "787-620-4747",
            "fax_number": "787-620-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON-QUETLAS",
        "first_name": "KERMIT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "5332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "27063",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERMIT",
            "last_name": "COLON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christian Carlos Colon Vega, MEDICAL STUDENT
• Lorena Colon-Anabitarte, PSY.D.
• Jose A Colon-Grau, MD
• Stephanie Colon-Lopez, MD
• Benedicto Colon-Perez, MD
• Maria Del Carmen Colon-Roig, M.D.
• Margarita Colon-Silva
• Angelita Colon, PSY.D.
• Benito A Colon Sr., SW
• Carlos Alberto Colon, PSY.D

• Internal Medicine Physician in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Internal Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.