Active NPI
Jose V Carrillo, MD
- Emergency Medicine Physician
- San German, PR
National Provider Identifier
1831287762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 5384
- Practice address
- Carr 2 KM 173 4
Hospital de la Concepcion
San German, PR 00683 - Phone
- (787) 892-1860
- NPI assigned
- Oct 10, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5384 | PR | Primary |
Addresses
Primary practice location
Carr 2 KM 173 4
Hospital de la Concepcion
San German, PR 00683
Mailing address
PO Box 7999
Suite 206
Mayaguez, PR 00681
Phone (787) 834-1342
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5380 | PR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinica Yaguez, Inc. | Emergency Medicine | Current | Accepting new patients |
| Clinica Yaguez, Inc | Current | Accepting new patients | |
| Hospital de la Concepcion Inc | Past | Accepting new patients |
Locations
117 Calle Ramon Valdes
Mayaguez, PR 00680
Phone (787) 832-8445
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- San German, PR
- NPI 1366484594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831287762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7999",
"address_2": "SUITE 206",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "00681",
"telephone_number": "787-834-1342",
"fax_number": "787-805-4436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 2 KM 173 4",
"address_2": "HOSPITAL DE LA CONCEPCION",
"city": "SAN GERMAN",
"state": "PR",
"postal_code": "00683",
"telephone_number": "787-892-1860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "JOSE",
"middle_name": "V",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "PR",
"license": "5384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San German, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.