Individual provider Active NPI

Luis Santiago Capellan, MD

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1790993053
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
6397 Issued in PR
Practice address
2787 Calle Las Carrozas
Urb Perla del Sur
Ponce, PR 00717-0405
Phone
(787) 842-4586
Fax
(787) 842-4586
NPI assigned
May 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 6397 PR Primary

Addresses

Primary practice location

2787 Calle Las Carrozas
Urb Perla del Sur
Ponce, PR 00717-0405

Mailing address

2787 Calle Las Carrozas
Urb Perla del Sur
Ponce, PR 00717-0405
Phone (787) 842-4586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6397PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790993053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2787 CALLE LAS CARROZAS",
            "address_2": "URB PERLA DEL SUR",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170405",
            "telephone_number": "787-842-4586",
            "fax_number": "787-842-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2787 CALLE LAS CARROZAS",
            "address_2": "URB PERLA DEL SUR",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170405",
            "telephone_number": "787-842-4586",
            "fax_number": "787-842-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPELLAN",
        "first_name": "LUIS",
        "middle_name": "SANTIAGO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "6397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.