Individual provider Active NPI

Omar Marrero Mesa

  • General Practice Physician
  • Aguadilla, PR
National Provider Identifier
1912285545
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
18277 Issued in PR
Practice address
492 Avenida Victoria
Aguadilla, PR 00603
Phone
(787) 891-3054
Fax
(787) 891-3054
NPI assigned
Aug 1, 2011
Last updated
Apr 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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 18277 PR Primary

Addresses

Primary practice location

492 Avenida Victoria
Aguadilla, PR 00603

Mailing address

492 Victoria Ave.
Aguadilla, PR 00603
Phone (787) 891-3054

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
I20110829000218 PR Practitioner - General Practice 3971773060 Practice locations: Juncos, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18277PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Farma Ahorros PastSince Jan 31, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1912285545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492 VICTORIA AVE.",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-891-3054",
            "fax_number": "787-891-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 AVENIDA VICTORIA",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-891-3054",
            "fax_number": "787-891-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO MESA",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguadilla, PR

Sources for this page

Verify at the official NPI Registry.