Angel David Sem Casillas Carmona, MHS
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · San Juan, PR
NPI 1962263095 · NPPES record last updated Nov 1, 2024
Key facts
- NPI
- 1962263095
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 3 Calle Hortensia Apt 12G
San Juan, PR 00926-6416 - Phone
- (787) 220-5461
- NPI assigned
- Jan 16, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Addiction Medicine
- Education
- University Central del Caribe Escuela de Medicina, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Neomed Center, Inc
Practice addresses (Care Compare)
Urb Lago Alto
Calle Carite 130
Trujillo Alto, PR 00976-6007
Phone 78773723112058
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240806000095 | PR | Practitioner - Addiction Medicine | 4082151238 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4699 | PR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neomed Center, Inc | Current |
Accepting new patients | |
| Neomed Center, Inc. | Current |
Accepting new patients | |
| Neomed Center, Inc | Current | Accepting new patients |
Locations
130 Calle Carite
Trujillo Alto, PR 00976
Phone (787) 292-3120
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
3 Calle Hortensia Apt 12G
San Juan, PR 00926-6416
Mailing address
CC42 Calle 14
Rio Grande, PR 00745-5130
Phone (787) 220-5461
Other providers in San Juan, PR
- Beatriz Casellas
- Nicolas Javier Casellas
- Casiano Consulting Services
- Vanessa Virginia Casillas Burgos
- Gretchen Nicole Casillas Canales
- Frances Enid Casillas Chiesa
- Casillas Psychological Services LLC
- Angel Emmanuel Casillas Rodriguez
- Franchard Casimir
- Edna Mercedes Castaneda Torres
All providers in San Juan, PR · Addiction (Substance Use Disorder) Counselor in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.