Individual provider Active NPI

Jose Miguel Maldonado Cortes, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1831217835
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4153 Issued in PR
Practice address
Calle Maga Final Terrenos Hospital Siquiatria
Pabellon G Centro Medico
San Juan, PR 00928-0000
Phone
(787) 754-4100
Fax
(787) 767-9243
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4153 PR Primary

Addresses

Primary practice location

Calle Maga Final Terrenos Hospital Siquiatria
Pabellon G Centro Medico
San Juan, PR 00928-0000

Mailing address

S2 Calle 3 No 4
Villas de Parana
San Juan, PR 00926-0000
Phone (787) 720-4637

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
I20151209001713 PR Order and Referring Only - General PracticePractitioner - General Practice 9234430695

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4153PRMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831217835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S2 CALLE 3 NO 4",
            "address_2": "VILLAS DE PARANA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009260000",
            "telephone_number": "787-720-4637",
            "fax_number": "787-720-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE MAGA FINAL TERRENOS HOSPITAL SIQUIATRIA",
            "address_2": "PABELLON G CENTRO MEDICO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009280000",
            "telephone_number": "787-754-4100",
            "fax_number": "787-767-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO CORTES",
        "first_name": "JOSE",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "4153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.