Individual provider Active NPI

Enrique Agustin Padro I, M.D.

  • Diagnostic Radiology Physician
  • Carolina, PR
National Provider Identifier
1891833240
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
6621 Issued in PR
Practice address
E17 Calle Malaga
Vistamar Marina
Carolina, PR 00983-1507
Phone
(787) 768-6661
Fax
(787) 757-6935
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 6621 PR Primary

Addresses

Primary practice location

E17 Calle Malaga
Vistamar Marina
Carolina, PR 00983-1507

Mailing address

E17 Calle Malaga
Vistamar Marina
Carolina, PR 00983-1507
Phone (787) 768-6661

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
I20060324000022 PR Practitioner - Diagnostic Radiology 8628086295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Servicios Medicos Universitarios IncGroup PAC ID 5395838882, 5 clinicians

Practice addresses (Care Compare)

7200 Ave 65 Infanteria
Carolina, PR 00985-5575
Phone (787) 757-1800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6621PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas Diagnostic Radiology CurrentSince Aug 15, 2016 Accepting new patients
Servicios Medicos Universitarios Inc Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients
Recinto de Ciencias Medicas CurrentSince Aug 15, 2016 Accepting new patients
Fajardo Imaging MRI CSP Diagnostic Radiology PastSince Jun 11, 2011 Accepting new patients

Locations

7200 Ave 65 Infanteria
Carolina, PR 00985

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891833240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E17 CALLE MALAGA",
            "address_2": "VISTAMAR MARINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009831507",
            "telephone_number": "787-768-6661",
            "fax_number": "787-757-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E17 CALLE MALAGA",
            "address_2": "VISTAMAR MARINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009831507",
            "telephone_number": "787-768-6661",
            "fax_number": "787-757-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADRO",
        "first_name": "ENRIQUE",
        "middle_name": "AGUSTIN",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PR",
            "license": "6621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.