Michael Nelson Fucile, M.D.

Individual provider Active NPI Family Medicine Physician · Corozal, PR

NPI 1962422006 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1962422006
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
7745 (PR)
Practice address
Rd.159 Desvio KM.0.8
Corozal, PR 00783-0739
Phone
(787) 859-2560
Fax
(787) 859-5390
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 13

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.

Medicare Care Compare profile

Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Integral En la Montana Inc (64 clinicians)

Practice addresses (Care Compare)

Carr 891 KM
1 Bo Pueblo
Corozal, PR 00783-2441
Phone (787) 859-2560

Carr PR
891 Esquina Carr PR 159
Corozal, PR 00783
Phone (787) 859-2560

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 IDStateProvider typePAC IDDetails
I20101115000541 PR Practitioner - Family Practice 2466647516 Reassigns benefits to 5 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7745PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc Family Medicine Current
since May 15, 2019
Accepting new patients
Salud Integral En la Montana, Inc Current
since Oct 1, 1984
Accepting new patients
Salud Integral En la Montana, Inc Current Accepting new patients
Salud Integral En la Montana, Inc. Current
since Oct 1, 1984
Accepting new patients
Salud Integral En la Montana, Inc. Current
since May 15, 2019
Accepting new patients
Salud Integral En la Montana, Inc Current
since May 15, 2019
Accepting new patients
Salud Integral En la Montana, Inc. Family Medicine Current
since May 15, 2019
Accepting new patients

Locations

156 Calle Barcelo
#53
Barranquitas, PR 00794
Phone (787) 857-2688

18 Calle Gerardo Nieves Mercado
Comerio, PR 00782

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7745 PR Yes

Addresses

Primary practice location

Rd.159 Desvio KM.0.8
Corozal, PR 00783-0739

Mailing address

PO Box 739
Corozal, PR 00783-0739
Phone (787) 859-2560

Other providers in Corozal, PR

All providers in Corozal, PR · Family Medicine Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.