Individual provider Active NPI

Juan Sebastian Proano Coello, MD

  • Pediatric Critical Care Medicine Physician
  • Huntington, WV
National Provider Identifier
1952752628
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
31361 Issued in WV
Practice address
1600 Medical Center Dr Ste 3500
Huntington, WV 25701-3655
Phone
(304) 691-1300
Fax
(304) 691-1375
NPI assigned
Jun 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Critical Care Medicine Physician 2080P0203X 31361 WV Primary

Addresses

Primary practice location

1600 Medical Center Dr Ste 3500
Huntington, WV 25701-3655

Mailing address

1448 10TH Ave Ste 304
Huntington, WV 25701-3579
Phone (304) 691-8722

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address juan.proanocoello@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20220829002091 WV Practitioner - Pediatric Medicine 9931447976 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc CurrentSince Aug 15, 2022 Accepting new patients
University Physicians & Surgeons, Inc. CurrentSince Aug 15, 2022 Accepting new patients
Cabell Huntington Hospital Inc Past Accepting new patients

Locations

1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

1448 10th Ave
Ste 304
Huntington, WV 25701
Phone (304) 691-6381

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.

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1952752628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 10TH AVE STE 304",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013579",
            "telephone_number": "304-691-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR STE 3500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013655",
            "telephone_number": "304-691-1300",
            "fax_number": "304-691-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROANO COELLO",
        "first_name": "JUAN SEBASTIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "WV",
            "license": "31361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "juan.proanocoello@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Dr Ste 3500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.