Individual provider Active NPI

Guillermo Tirado Santos

  • Family Medicine Physician
  • Cidra, PR
National Provider Identifier
1902427503
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23772 Issued in PR
Practice address
KM 4.8 Carr 787 Ste 2
Cidra, PR 00739
Phone
(787) 739-4624
NPI assigned
May 5, 2020
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23772 PR Primary

Addresses

Primary practice location

KM 4.8 Carr 787 Ste 2
Cidra, PR 00739

Mailing address

4700 Carr 787
Cidra, PR 00739-2189

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
I20240614003801 PR Practitioner - Family PracticePractitioner - General Practice 4789127044 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Menonita de CayeyGroup PAC ID 2466449657, 57 clinicians
Hospital Menonita Caguas IncGroup PAC ID 8921254780, 48 clinicians

Practice addresses (Care Compare)

Bo Bayamon Carr KM
8 Suite 2
Cidra, PR 00739
Phone (787) 974-5307

Carretera 14 Interior
Bo Rincon
Cayey, PR 00737-2800
Phone (787) 434-1700

PO Box
Suite 372800
Cayey, PR 00737-2800

Salida 21 Caguas a Cidra
Urb Turabo Garden
Caguas, PR 00725-0000
Phone (787) 434-1700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Menonita de Cayey General Practice CurrentSince Jul 18, 2024 Accepting new patients
Hospital Menonita Caguas Inc Family Medicine CurrentSince Dec 23, 2024 Accepting new patients
Cava Health CurrentSince Apr 16, 2024 Accepting new patients
Hospital Menonita de Cayey Current Accepting new patients
Hospital Menonita Caguas Inc CurrentSince Dec 23, 2024 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1902427503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 CARR 787",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007392189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KM 4.8 CARR 787 STE 2",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "00739",
            "telephone_number": "787-739-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRADO SANTOS",
        "first_name": "GUILLERMO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-05",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "23772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cidra, PR

Sources for this page

Verify at the official NPI Registry.