Active NPI
Lisandra Cordero Nieves, M.D.
- Obstetrics Physician
- Ponce, PR
National Provider Identifier
1841534823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics Physician
- License
- 19375
- Practice address
- PR 505 KM 1.0 Urb Glenview Gardens
Glenview Gardens Shopping Center Local #4
Ponce, PR 00731 - Phone
- (787) 812-3153
- NPI assigned
- Nov 15, 2012
- Last updated
- Oct 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Obstetrics Physician | 207VX0000X | 19375 | PR | Primary |
Addresses
Primary practice location
PR 505 KM 1.0 Urb Glenview Gardens
Glenview Gardens Shopping Center Local #4
Ponce, PR 00731
Mailing address
P O Box 102
Mercedita, PR 00715
Phone (787) 812-3153
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19375 | Other | PR | LIC |
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 |
|---|---|---|---|
| 19375 | PR | MD | Obstetrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jem Medical Group LLC | Past | Accepting new patients |
Interoperability endpoints
- lisandra.corderonieves@3292.securemail.prognocis.com
Organizations & group practices 2
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.
-
- Obstetrics Physician
- Ponce, PR
- NPI 1730637471
-
- Obstetrics & Gynecology Physician
- Coto Laurel, PR
- NPI 1508799800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475798400000",
"number": "1841534823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 102",
"city": "MERCEDITA",
"state": "PR",
"postal_code": "00715",
"telephone_number": "787-812-3153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PR 505 KM 1.0 URB GLENVIEW GARDENS",
"address_2": "GLENVIEW GARDENS SHOPPING CENTER LOCAL #4",
"city": "PONCE",
"state": "PR",
"postal_code": "00731",
"telephone_number": "787-812-3153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDERO NIEVES",
"first_name": "LISANDRA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2016-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": "PR",
"license": "19375",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIC",
"identifier": "19375",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.