Jossepp Berry-Polanco, MD

Individual provider Active NPI General Practice Physician · Carolina, PR

NPI 1831185271 · NPPES record last updated Feb 25, 2010

Key facts

NPI
1831185271
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
7962 (PR)
Practice address
Ave Sanchez Osorio 2Tr511
Villa Fontana
Carolina, PR 00983-3226
Phone
(787) 757-8065
Fax
(787) 768-8392
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20031112000027 PR Practitioner - General Practice 8224941570 Practice locations: Carolina, PR

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7962PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ges de San Juan, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 7962 PR Yes

Addresses

Primary practice location

Ave Sanchez Osorio 2Tr511
Villa Fontana
Carolina, PR 00983-3226

Mailing address

Bloque 31 Calle 31 # 8
Villa Asturias
Carolina, PR 00985-5755
Phone (787) 529-5093

Other providers in Carolina, PR

All providers in Carolina, PR · General Practice Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.