Ivan F Marrero, D.M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

653 Issued in PR

Practice address

611 Calle Pavia
Pavia Medical Plaza Suite 208
Santurce, PR 00909-2239

Phone

(787) 268-3200

Fax

(787) 268-4045

NPI assigned

Nov 30, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sjcimarrer@yourcarecommunity.org

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.

• Recinto de Ciencias Medicas

  • Oral & Maxillofacial Surgery (D.M.D.)
  • San Juan, PR
  • NPI 1205868676
  NPD (past)

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1881678340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 CALLE PAVIA",
            "address_2": "PAVIA MEDICAL PLAZA SUITE 208",
            "city": "SANTURCE",
            "state": "PR",
            "postal_code": "009092239",
            "telephone_number": "787-268-3200",
            "fax_number": "787-268-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 CALLE PAVIA",
            "address_2": "PAVIA MEDICAL PLAZA SUITE 208",
            "city": "SANTURCE",
            "state": "PR",
            "postal_code": "009092239",
            "telephone_number": "787-268-3200",
            "fax_number": "787-268-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO",
        "first_name": "IVAN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PR",
            "license": "653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maribel Malave, PH
• Victor Kevin Maldonado, M.D.
• Jose A Marques Bibiloni Sr., MD
• Domingo J. Marques, PSY.D.
• Doris A Marrero
• Esteban Martinez Lugo
• Jaime Martinez-Souss, M.D.
• Jose L Martinez, MD
• Master Orthopedic Inc
• MDM Group

• Oral & Maxillofacial Surgery (D.M.D.) in Santurce, PR
• Providers in Santurce, PR by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.

Verify at the official NPI Registry.