Rio Grande Medical Services CSP

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

11192 Issued in PR

Legal business name

RIO GRANDE MEDICAL SERVICES CSP

Practice address

Calle Pimentel Castro Num. 200
Rio Grande, PR 00745-6600

Phone

(787) 657-5557

Fax

(787) 657-5557

NPI assigned

Oct 20, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Ismael Morales Diaz, 11192NPI 1568557288

Title

President

Phone

(787) 384-5045

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ismael Morales Diaz, M.D.

  • General Practice Physician
  • Rio Grande, PR
  • NPI 1568557288
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1952852311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43001",
            "address_2": "DPT.471",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "007456600",
            "telephone_number": "787-384-5045",
            "fax_number": "787-657-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE PIMENTEL CASTRO NUM. 200",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "007456600",
            "telephone_number": "787-657-5557",
            "fax_number": "787-657-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO GRANDE MEDICAL SERVICES CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "MORALES DIAZ",
        "authorized_official_first_name": "ISMAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-384-5045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "11192"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "PR",
            "license": "11192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RG Dental PSC
• RG Prosthetics MFG. Corp
• Rio Grande Diagnostic CSP
• Rio Grande Medical Group
• Rio Grande Medical Group
• Rio Grande Nuclear PSC
• Karmari Rios, MSW
• Ninna S Rivera Correa
• Alyris Rivera Perez
• Patricia A Rivera Santana, M.D.

• Health Service Clinic/Center in Rio Grande, PR
• Providers in Rio Grande, PR by specialty
• Health Service Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.