Organization Active NPI

Santa Maria Radiology, PSC

  • Diagnostic Radiology Physician
  • San Juan, PR
National Provider Identifier
1881621019
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11700 Issued in PR
Legal business name
SANTA MARIA RADIOLOGY, PSC
Practice address
310 Ave. Lomas Verdes Suite 208
San Juan, PR 00927-6638
Phone
(787) 751-3150
Fax
(787) 767-0338
NPI assigned
Jun 26, 2006
Last updated
Dec 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Authorized official

Name
Dr. Bernardo Jose Marques-Diaz, M.D.NPI 1013910231
Title
Director
Phone
(787) 751-3150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 11700 PR Primary

Addresses

Primary practice location

310 Ave. Lomas Verdes Suite 208
San Juan, PR 00927-6638

Mailing address

310 Ave. Lomas Verdes Suite 208
San Juan, PR 00927-6638
Phone (787) 751-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040515000522 PR Part B Supplier - Clinic/Group Practice 1153311691 Receives reassigned benefits from 2 practitioners
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

310 Ave Lomas Verdes
Ste 208
San Juan, PR 00927
Phone (787) 585-0385

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1881621019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 AVE. LOMAS VERDES SUITE 208",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009276638",
            "telephone_number": "787-751-3150",
            "fax_number": "787-767-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 AVE. LOMAS VERDES SUITE 208",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009276638",
            "telephone_number": "787-751-3150",
            "fax_number": "787-767-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA MARIA RADIOLOGY, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "MARQUES-DIAZ",
        "authorized_official_first_name": "BERNARDO",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-751-3150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PR",
            "license": "11700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.