NPIMap

Organization Active NPI

North Shore Medical Group LLC

  • Internal Medicine Physician
  • Vega Baja, PR
National Provider Identifier
1801334883
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16634 Issued in PR
Legal business name
NORTH SHORE MEDICAL GROUP LLC
Practice address
39 Carr 2
Hospital Wilma N Vazquez Suite 101
Vega Baja, PR 00693-4824
Phone
(787) 858-3550
Fax
(787) 855-3339
NPI assigned
Feb 9, 2017
Last updated
Feb 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Dr. Ana M Rodriguez - Portela, MDNPI 1851452130
Title
President
Phone
(787) 345-9682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 16634 PR Primary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X 14001 PR

Addresses

Primary practice location

39 Carr 2
Hospital Wilma N Vazquez Suite 101
Vega Baja, PR 00693-4824

Mailing address

781 Calle Arrayado
Urb. San Demetrio
Vega Baja, PR 00693
Phone (787) 858-3550

National Provider Directory

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1801334883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 CALLE ARRAYADO",
            "address_2": "URB. SAN DEMETRIO",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00693",
            "telephone_number": "787-858-3550",
            "fax_number": "787-855-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 CARR 2",
            "address_2": "HOSPITAL WILMA N VAZQUEZ SUITE 101",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006934824",
            "telephone_number": "787-858-3550",
            "fax_number": "787-855-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ - PORTELA",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-345-9682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "16634",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "14001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.