Individual provider Active NPI

Michael Nelson Fucile, M.D.

  • Family Medicine Physician
  • Corozal, PR
National Provider Identifier
1962422006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7745 Issued in 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
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

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

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

Medicare participation

Medicare enrollment files
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

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Integral En la Montana IncGroup PAC ID 8527972827, shared by 11 NPIs, 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

National Provider Directory

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

Practice roles

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

Locations

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

18 Calle Gerardo Nieves Mercado
Comerio, PR 00782

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962422006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 739",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "007830739",
            "telephone_number": "787-859-2560",
            "fax_number": "787-859-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RD.159 DESVIO KM.0.8",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "007830739",
            "telephone_number": "787-859-2560",
            "fax_number": "787-859-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUCILE",
        "first_name": "MICHAEL",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "7745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corozal, PR

Sources for this page

Verify at the official NPI Registry.