Individual provider Active NPI

Ibis Morales, M.D.

  • Pediatrics Physician
  • Bayamon, PR
National Provider Identifier
1912064494
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
8588 Issued in PR
Practice address
Jardines de Bayamonte
85 Calle Gorrion
Bayamon, PR 00956-6639
Phone
(787) 740-1742
Fax
(787) 740-1742
NPI assigned
Jan 3, 2007
Sex
Female
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
Pediatrics Physician 208000000X 8588 PR Primary

Addresses

Primary practice location

Jardines de Bayamonte
85 Calle Gorrion
Bayamon, PR 00956-6639

Mailing address

Jardines de Bayamonte
85 Calle Gorrion
Bayamon, PR 00956-6639
Phone (787) 740-1742

Other identifiers 1

IdentifierTypeStateIssuer
2-9881OtherPRSSS PROVIDER NUMBER

Other names 1

  • Ibis Morales-Montalvo Other name

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
I20160412000824 PR Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5496053290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8588PRMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912064494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "JARDINES DE BAYAMONTE",
            "address_2": "85 CALLE GORRION",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009566639",
            "telephone_number": "787-740-1742",
            "fax_number": "787-740-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JARDINES DE BAYAMONTE",
            "address_2": "85 CALLE GORRION",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009566639",
            "telephone_number": "787-740-1742",
            "fax_number": "787-740-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "IBIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "8588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS PROVIDER NUMBER",
            "identifier": "2-9881",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IBIS",
            "last_name": "MORALES-MONTALVO",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.