NPIMap

Organization Active NPI

Advance Therapy Group PSC

  • Speech-Language Pathologist
  • Gurabo, PR
National Provider Identifier
1811150774
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1449-1 Issued in PR
Legal business name
ADVANCE THERAPY GROUP PSC
Practice address
Street 189 Marina Plaza
Suite 17-18
Gurabo, PR 00778
Phone
(787) 948-2866
Fax
(787) 737-6493
NPI assigned
Jul 9, 2008
Last updated
Nov 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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

Authorized official

Name
Ms. Nydia Gonzalez LopezNPI 1538312293
Title
Director
Phone
(787) 948-2866

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 763 PR
Occupational Therapist 225X00000X 983 PR
Speech-Language Pathologist 235Z00000X 824 PR
Speech-Language Pathologist 235Z00000X 1449-1 PR Primary

Addresses

Primary practice location

Street 189 Marina Plaza
Suite 17-18
Gurabo, PR 00778

Mailing address

HC 1 Box 26910
Caguas, PR 00725-8933
Phone (787) 948-2866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120424000494 PR Part B Supplier - Clinic/Group Practice 8527220367 Receives reassigned benefits from 2 practitioners
Practice locations: Gurabo, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226966400000",
    "number": "1811150774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 26910",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007258933",
            "telephone_number": "787-948-2866",
            "fax_number": "787-737-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STREET 189 MARINA PLAZA",
            "address_2": "SUITE 17-18",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-948-2866",
            "fax_number": "787-737-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE THERAPY GROUP PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-11-18",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ LOPEZ",
        "authorized_official_first_name": "NYDIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-948-2866",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PR",
            "license": "763",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PR",
            "license": "983",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "824",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "1449-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; 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.