Individual provider Active NPI

Juan Carlo Montalvo, M.D.

  • General Practice Physician
  • Yauco, PR
National Provider Identifier
1871798264
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16824 Issued in PR
Practice address
L22 Calle 12
La Quinta
Yauco, PR 00698-4117
Phone
(787) 267-7554
NPI assigned
Jun 18, 2007
Last updated
Oct 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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 16824 PR Primary

Addresses

Primary practice location

L22 Calle 12
La Quinta
Yauco, PR 00698-4117

Mailing address

L22 Calle 12
La Quinta
Yauco, PR 00698-4117
Phone (787) 267-7554

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
I20080212000129 PR Practitioner - General Practice 9739262940 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16824PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Consultoria Medica,CSP CurrentSince Oct 18, 2018 Accepting new patients

Locations

25 Calle Prol 25 de Julio
Yauco, PR 00698
Phone (787) 662-6699

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1871798264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "L22 CALLE 12",
            "address_2": "LA QUINTA",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006984117",
            "telephone_number": "787-267-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "L22 CALLE 12",
            "address_2": "LA QUINTA",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006984117",
            "telephone_number": "787-267-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTALVO",
        "first_name": "JUAN",
        "middle_name": "CARLO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yauco, PR

Sources for this page

Verify at the official NPI Registry.