Active NPI
Ivette Lebron, M.D.
- General Practice Physician
- Lares, PR
National Provider Identifier
1902017551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 16785
- Practice address
- Carr 129 KM 23.5
Lares, PR 00669-0000 - Phone
- (787) 897-8787
- Fax
- (787) 897-8787
- NPI assigned
- May 25, 2007
- Last updated
- Nov 5, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 16785 | PR | Primary |
Addresses
Primary practice location
Carr 129 KM 23.5
Lares, PR 00669-0000
Mailing address
PMB 112 PO Box 819
Lares, PR 00669-9607
Phone (787) 897-8787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16,785 | Other | PR | MD LICENSE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080506000150 | PR | Practitioner - General Practice | 0244319051 | Practice locations: Lares, PR |
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": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352073600000",
"number": "1902017551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PMB 112 PO BOX 819",
"city": "LARES",
"state": "PR",
"postal_code": "006699607",
"telephone_number": "787-897-8787",
"fax_number": "787-897-8787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 129 KM 23.5",
"city": "LARES",
"state": "PR",
"postal_code": "006690000",
"telephone_number": "787-897-8787",
"fax_number": "787-897-8787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBRON",
"first_name": "IVETTE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2012-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "16785",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD LICENSE",
"identifier": "16,785",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lares, PR
- Lares Medical Center Inc
- Lares Medical Center Inc.
- Lares Medical Center Vacuna
- Lares Medical Group
- Cristal Marie Latorre Roman
- Leoneland Ettienne Medical Response (Learning and Education Medical Response System, Corp)
- LMC Medical Ambulance LLC
- Jose Javier Lopez Lopez, MD
- Lopez Medical Equipment Inc
- Pedro Antonio Lopez Munoz
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.