NPIMap

Organization Active NPI

Mediko Imaging Inc.

  • Radiology Clinic/Center
  • Caguas, PR
National Provider Identifier
1831205236
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MEDIKO IMAGING INC.
Practice address
Ave. Jose Villares
#23 Condado Viejo
Caguas, PR 00725
Phone
(787) 743-1563
Fax
(787) 745-9637
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Authorized official

Name
Abner Gonzalez Costas
Title
Administrator
Phone
(787) 743-1563

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

Ave. Jose Villares
#23 Condado Viejo
Caguas, PR 00725

Mailing address

PO Box 8729
Caguas, PR 00726-8729
Phone (787) 743-1563

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090102000483 PR Part B Supplier - Clinic/Group Practice 8628042199 Receives reassigned benefits from 9 practitioners
Practice locations: Caguas, PR; Carolina, PR; Cayey, PR; Humacao, PR; Juncos, PR; Las Piedras, PR

National Provider Directory

National Provider Directory
Tax ID family
Mediko Imaging Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

57 Calle Munoz Rivera N
San Lorenzo, PR 00754
Phone (787) 736-0630

Practitioners & affiliated clinicians

Practitioners 10

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": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536883200000",
    "number": "1831205236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8729",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007268729",
            "telephone_number": "787-743-1563",
            "fax_number": "787-745-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. JOSE VILLARES",
            "address_2": "#23 CONDADO VIEJO",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-743-1563",
            "fax_number": "787-745-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIKO IMAGING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2018-09-14",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ COSTAS",
        "authorized_official_first_name": "ABNER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-743-1563"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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.