Edwin B. Antommattei, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

15484 Issued in PR

Practice address

167 Ave 5 de Diciembre
Sabana Grande, PR 00637-2421

Phone

(787) 978-7999

NPI assigned

Jan 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Municipio de Guanica

  • Emergency Care Clinic/Center
  • Guanica, PR
  • NPI 1205029709

  General Practice

  NPD (past)
• Municipio de Guanica

  • Clinical Medical Laboratory
  • Guanica, PR
  • NPI 1316182603
  NPD (past)
• RS Centro Medicina Avanzada, Corp

  • Family Medicine Physician
  • Coamo, PR
  • NPI 1346214129
  NPD (past)

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1841261443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1059",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "006371059",
            "telephone_number": "787-978-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 AVE 5 DE DICIEMBRE",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "006372421",
            "telephone_number": "787-978-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOMMATTEI",
        "first_name": "EDWIN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Activeaid Medical Solutions LLC
• Ad&D Therapy Alliance LLC
• Aitana Ponce LLC
• Alfredo Alicea
• Carla Patricia Almodovar Jusino, RN
• Aura Med Services LLC
• Robert William Axtmayer Carcache, MD
• Robert William Axtmayer, MD
• Jorge Luis Ayala-Colon, M.D.
• Stephanie Ayala, RN

• General Practice Physician in Sabana Grande, PR
• Providers in Sabana Grande, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.

Verify at the official NPI Registry.