Organization Active NPI

Clinicas de Medicinadel Norte CSP

  • Clinic/Center
  • Arecibo, PR
National Provider Identifier
1801198650
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
14040 Issued in PR
Legal business name
CLINICAS DE MEDICINADEL NORTE CSP
Practice address
Carr.#2 KM 62.8 Bo. Candelaria
Arecibo, PR 00612-0000
Phone
(787) 880-4014
Fax
(787) 880-4014
NPI assigned
Nov 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Mr. Juan R Marin, MD
Title
President
Phone
(787) 643-4747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 14040 PR Primary

Addresses

Primary practice location

Carr.#2 KM 62.8 Bo. Candelaria
Arecibo, PR 00612-0000

Mailing address

PO Box 140448
Arecibo, PR 00614-0448
Phone (787) 643-4747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191014001219 PR Part B Supplier - Clinic/Group Practice 4486985009 Receives reassigned benefits from 1 practitioner
Practice locations: Arecibo, PR

National Provider Directory

National Provider Directory
Tax ID family
Clinicas de Medicina del Norte CSP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1801198650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140448",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006140448",
            "telephone_number": "787-643-4747",
            "fax_number": "787-880-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR.#2 KM 62.8 BO. CANDELARIA",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006120000",
            "telephone_number": "787-880-4014",
            "fax_number": "787-880-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAS DE MEDICINADEL NORTE CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "MARIN",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-643-4747",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PR",
            "license": "14040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.