NPIMap

Organization Active NPI

Medicos Selectos del Norte Inc

  • General Practice Physician
  • Vega Alta, PR
National Provider Identifier
1932327665
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MEDICOS SELECTOS DEL NORTE INC
Practice address
Carr #2 KM 31 9 Barrio Bajura
Vega Alta, PR 00692
Phone
(787) 883-0124
Fax
(787) 883-7645
NPI assigned
Apr 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mildalias Dominguez Pascual, MD
Title
President
Phone
(787) 883-0124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

Carr #2 KM 31 9 Barrio Bajura
Vega Alta, PR 00692

Mailing address

P.O. Box 4317
Puerto Rico, PR 00694-4317
Phone (787) 883-0124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150507002390 PR Part B Supplier - Clinic/Group Practice 6305165671 Receives reassigned benefits from 18 practitioners
Practice locations: Vega Alta, PR

National Provider Directory

National Provider Directory
Tax ID family
Medicos Selectos del Norte Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932327665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 4317",
            "city": "PUERTO RICO",
            "state": "PR",
            "postal_code": "006944317",
            "telephone_number": "787-883-0124",
            "fax_number": "787-883-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #2 KM 31 9 BARRIO BAJURA",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "00692",
            "telephone_number": "787-883-0124",
            "fax_number": "787-883-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOS SELECTOS DEL NORTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PASCUAL",
        "authorized_official_first_name": "MILDALIAS",
        "authorized_official_middle_name": "DOMINGUEZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-883-0124",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Alta, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.