Organization Active NPI

Internal Medicine and Preventive Care Service CSP

  • Internal Medicine Physician
  • Bayamon, PR
National Provider Identifier
1801879135
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERNAL MEDICINE AND PREVENTIVE CARE SERVICE CSP
Practice address
Bayamon Medical PLZ
Suite 505
Bayamon, PR 00959-7200
Phone
(787) 269-3015
Fax
(787) 740-4720
NPI assigned
Nov 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Authorized official

Name
Dr. Arizmendi Angel, MD
Title
President
Phone
(787) 269-3015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

Bayamon Medical PLZ
Suite 505
Bayamon, PR 00959-7200

Mailing address

Bayamon Medical PLZ
Suite 505
Bayamon, PR 00959-7200
Phone (787) 269-3015

Other identifiers 1

IdentifierTypeStateIssuer
84901OtherT-S

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080508000114 PR Part B Supplier - Clinic/Group Practice 2163501776 Receives reassigned benefits from 2 practitioners
Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory

Locations

1845 Carr 2
Ste 505
Bayamon, PR 00959
Phone (787) 269-3015

Practitioners & affiliated clinicians

Practitioners 2

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": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1801879135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BAYAMON MEDICAL PLZ",
            "address_2": "SUITE 505",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009597200",
            "telephone_number": "787-269-3015",
            "fax_number": "787-740-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BAYAMON MEDICAL PLZ",
            "address_2": "SUITE 505",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009597200",
            "telephone_number": "787-269-3015",
            "fax_number": "787-740-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE AND PREVENTIVE CARE SERVICE CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "ANGEL",
        "authorized_official_first_name": "ARIZMENDI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-269-3015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "T-S",
            "identifier": "84901",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.