Individual provider Active NPI

Jorge J Lastra, M.D.

  • Neurological Surgery Physician
  • Manati, PR
National Provider Identifier
1952467490
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
13229 Issued in PR
Practice address
Manati Medical Center
Suite 201
Manati, PR 00674
Phone
(787) 621-3737
Fax
(787) 621-3251
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 13229 PR Primary

Addresses

Primary practice location

Manati Medical Center
Suite 201
Manati, PR 00674

Mailing address

Manati Medical Center
Suite 201
Manati, PR 00674
Phone (787) 621-3737

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
I20200405000155 PR Practitioner - Neurosurgery 1759346760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Puerto Rico School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Calle Jose D Candelas
Suite 201
Manati, PR 00674-5526
Phone (787) 621-3737

Hospital & facility affiliations

  • Manati Medical Center Dr Otero Lopez Hospital, Manati, PR, CCN 400114

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13229PRMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Puerto Rico Neurosurgery & Spine, LLC Neurological Surgery CurrentSince Mar 9, 2020 Accepting new patients
Complete Neuro GNM, PSC Past Accepting new patients
Recinto de Ciencias Medicas Neurological Surgery Past Accepting new patients

Locations

425 Carr 693
Ste 1
Dorado, PR 00646
Phone (787) 221-2751

Organizations & group practices 3

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

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254096000000",
    "number": "1952467490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MANATI MEDICAL CENTER",
            "address_2": "SUITE 201",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-621-3737",
            "fax_number": "787-621-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MANATI MEDICAL CENTER",
            "address_2": "SUITE 201",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-621-3737",
            "fax_number": "787-621-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASTRA",
        "first_name": "JORGE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2009-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PR",
            "license": "13229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.