Individual provider Active NPI

Jose Cumba Guerrero

  • General Practice Physician
  • Toa Alta, PR
National Provider Identifier
1811041825
Registry record updated Jan 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14079 Issued in PR
Practice address
Palacios del Rio II
Calle Cibuco 766
Toa Alta, PR 00953
Phone
(787) 390-0578
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2012

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 14079 PR Primary

Addresses

Primary practice location

Palacios del Rio II
Calle Cibuco 766
Toa Alta, PR 00953

Mailing address

Palacios del Rio II
Calle Cibuco 766
Toa Alta, PR 00953-5116
Phone (787) 390-0578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109000942 PR Practitioner - General Practice 8527086347 Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

31 Calle 49 Bloque 51 Ave Main
Urb Sierra Bayamon
Bayamon, PR 00960
Phone (787) 778-4821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14079PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Medicina Preventiva CSP General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1811041825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PALACIOS DEL RIO II",
            "address_2": "CALLE CIBUCO 766",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009535116",
            "telephone_number": "787-390-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PALACIOS DEL RIO II",
            "address_2": "CALLE CIBUCO 766",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "00953",
            "telephone_number": "787-390-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMBA GUERRERO",
        "first_name": "JOSE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Alta, PR

Sources for this page

Verify at the official NPI Registry.