Individual provider Active NPI

Luis Alberto Lopez Castro, M.D.

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1881742021
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
10856 Issued in PR
Practice address
3047 Ave Emilio Fagot
Ponce, PR 00716-4115
Phone
(787) 841-7194
Fax
(787) 841-7194
NPI assigned
Jan 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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 10856 PR Primary

Addresses

Primary practice location

3047 Ave Emilio Fagot
Ponce, PR 00716-4115

Mailing address

PO Box 7670
Ponce, PR 00732-7670
Phone (787) 841-7194

Other identifiers 1

IdentifierTypeStateIssuer
10856OtherPRSTATE 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
I20161107000495 PR Order and Referring Only - General PracticePractitioner - General Practice 5698081594

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1881742021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7670",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007327670",
            "telephone_number": "787-841-7194",
            "fax_number": "787-841-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3047 AVE EMILIO FAGOT",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164115",
            "telephone_number": "787-841-7194",
            "fax_number": "787-841-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ CASTRO",
        "first_name": "LUIS",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-06",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "10856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "10856",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.