Centro Renal de Bayamon

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

95226 Issued in PR

Legal business name

CENTRO RENAL DE BAYAMON

Practice address

Santa Juanita Shopping Court
Calle 30 Esquina 41
Bayamon, PR 00956

Phone

(787) 288-5555

Fax

(787) 786-9824

NPI assigned

Aug 31, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jose R Martinez

Title

President

Phone

(787) 288-5555

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962514414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EL SENORIAL MAIL STATION MSC 536",
            "address_2": "WINSTON CHURCHILL 138",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-288-5555",
            "fax_number": "787-786-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SANTA JUANITA SHOPPING COURT",
            "address_2": "CALLE 30 ESQUINA 41",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-288-5555",
            "fax_number": "787-786-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO RENAL DE BAYAMON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-288-5555"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "PR",
            "license": "95226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL PROVIDER NUMBE",
            "identifier": "17964",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bayamon, PR
• Providers in Bayamon, PR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.