Organization Active NPI

Ortho Evolution LLC

  • Orthopaedic Surgery Physician
  • Manati, PR
National Provider Identifier
1962713131
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHO EVOLUTION LLC
Practice address
Num 54 Local 14 Plaza Puerta del Sol
Manati, PR 00674-0000
Phone
(787) 621-2121
Fax
(787) 621-0818
NPI assigned
Jun 23, 2010
Last updated
Aug 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Authorized official

Name
Dr. Carlos Ivan Carrion, MD
Title
Presidente
Phone
(787) 621-2121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

Num 54 Local 14 Plaza Puerta del Sol
Manati, PR 00674-0000

Mailing address

PO Box 787
Manati
Manati, PR 00674-0787
Phone (787) 621-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130829000370 PR Part B Supplier - Clinic/Group Practice 6608019278 Receives reassigned benefits from 1 practitioner
Practice locations: Manati, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1962713131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 787",
            "address_2": "MANATI",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740787",
            "telephone_number": "787-621-2121",
            "fax_number": "787-621-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NUM 54 LOCAL 14 PLAZA PUERTA DEL SOL",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740000",
            "telephone_number": "787-621-2121",
            "fax_number": "787-621-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO EVOLUTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-23",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "CARRION",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "IVAN",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-621-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.