Individual provider Active NPI

Jossepp Berry-Polanco, MD

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1831185271
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
7962 Issued in 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
Last updated
Feb 25, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

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 7962 PR Primary

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

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
I20031112000027 PR Practitioner - General Practice 8224941570 Practice locations: Carolina, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7962PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ges de San Juan, Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1831185271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLOQUE 31 CALLE 31 # 8",
            "address_2": "VILLA ASTURIAS",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855755",
            "telephone_number": "787-529-5093",
            "fax_number": "787-768-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE SANCHEZ OSORIO 2TR511",
            "address_2": "VILLA FONTANA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009833226",
            "telephone_number": "787-757-8065",
            "fax_number": "787-768-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY-POLANCO",
        "first_name": "JOSSEPP",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2010-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "7962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.