Individual provider Active NPI

Marien Santaella Irizarry, MD

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1851332480
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16232 Issued in PR
Practice address
5151 Calle Lucas Amadeo
Ponce, PR 00717-1210
Phone
(787) 286-6060
Fax
(787) 286-6161
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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 16232 PR Primary

Addresses

Primary practice location

5151 Calle Lucas Amadeo
Ponce, PR 00717-1210

Mailing address

5151 Calle Lucas Amadeo
Ponce, PR 00717-1210

Other identifiers 1

IdentifierTypeStateIssuer
16232OtherPRPRACTICE LICENCE

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
I20060331000338 PR Practitioner - General Practice 9638187743 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16232PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ER Specialized Care LLC CurrentSince Oct 7, 2017 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Dec 26, 2010 Accepting new patients
Centro Medico del Turabo Inc General Practice CurrentSince Dec 26, 2010 Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1851332480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 CALLE LUCAS AMADEO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 CALLE LUCAS AMADEO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171210",
            "telephone_number": "787-286-6060",
            "fax_number": "787-286-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTAELLA IRIZARRY",
        "first_name": "MARIEN",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE LICENCE",
            "identifier": "16232",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.