Omar Berrios Torres, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

23080 Issued in PR

Practice address

Urb Santa Elena
Ee12 Calle 3 a
Bayamon, PR 00957-1734

Phone

(939) 625-3503

NPI assigned

Nov 17, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• JC Fast Clinic LLC

  • General Practice Physician
  • Toa Baja, PR
  • NPI 1861051906

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1962005637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 AVE COMERIO MARGINAL LEVITTOWN",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "00949",
            "telephone_number": "787-784-2218",
            "fax_number": "787-784-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB SANTA ELENA",
            "address_2": "EE12 CALLE 3 A",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009571734",
            "telephone_number": "939-625-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRIOS TORRES",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-17",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "15460I",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "23080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yanira Bermudez, PHARM. D.
• Natalia Bernal Fernandez, PSYD
• Mario Felipe Bernal Pablos Jr., M.D.
• Delfin V Bernal, M.D.
• Genesis Ivette Berrios Cancel
• Rafael Berrios-Marcano, M.D.
• Krystal Berrios-Morales, PHARMD, RPH
• Alma Iris Berrios, RPH
• Carlos Miguel Berrios, MA
• Elsa Berrios

• All providers in Bayamon, PR
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.