Endourological Institute Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

14 Issued in PR

Legal business name

ENDOUROLOGICAL INSTITUTE INC

Doing business as

Centro Cirugia Ambulatorio Procedimientos Urologicos

Practice address

Endourological Institute Inc-Centro Cirugia Ambulatoria
735 Ave Ponce de Leon Suite 608-612 Torre Auxilio Mutuo
San Juan, PR 00917-5028

Phone

(787) 777-8181

Fax

(787) 777-8180

NPI assigned

Aug 22, 2006

Organization subpart

No

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

Authorized official

Name

Pablo E Cardona Doble, MDNPI 1679522411

Title

President Endourological Institute

Phone

(787) 777-8181

Specialties & licenses 2

Addresses

Other identifiers 8

Other names 1

• Centro Cirugia Ambulatorio Procedimientos Urologicos Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Listed as

Endourological Institute IncCCN 40C0001025

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pablo Efren Cardona Doble

  • Urology Physician
  • San Juan, PR
  • NPI 1679522411
  NPD Authorized official
• Alfredo A. Rivera, M.D.

  • Anesthesiology Physician
  • St. Thomas, VA
  • NPI 1386790707
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1871609610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 AVENIDA PONCE DE LEON",
            "address_2": "TORRE DE AUXILIO MUTUO SUITE 608",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175028",
            "telephone_number": "787-777-8181",
            "fax_number": "787-777-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ENDOUROLOGICAL INSTITUTE INC-CENTRO CIRUGIA AMBULATORIA",
            "address_2": "735 AVE PONCE DE LEON SUITE 608-612 TORRE AUXILIO MUTUO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175028",
            "telephone_number": "787-777-8181",
            "fax_number": "787-777-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOUROLOGICAL INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2023-09-13",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "CARDONA DOBLE",
        "authorized_official_first_name": "PABLO",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT ENDOUROLOGICAL INSTITUTE",
        "authorized_official_telephone_number": "787-777-8181",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PR",
            "license": "14",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038600400",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "18038",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED",
            "identifier": "600226",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "9170053",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "030193",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROSSAM",
            "identifier": "3602-2",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HEALTH, INC.",
            "identifier": "00344",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UIA",
            "identifier": "LB-45464",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centro Cirugia Ambulatorio Procedimientos Urologicos",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in San Juan, PR
• Providers in San Juan, PR by specialty
• Ambulatory Surgical Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.