NPIMap

Organization Active NPI

Spine Sports and Manual Medicine Clinic PSC

  • Physical Medicine & Rehabilitation Physician
  • Guaynabo, PR
National Provider Identifier
1972696649
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SPINE SPORTS AND MANUAL MEDICINE CLINIC PSC
Practice address
221 Carr 2
Guaynabo, PR 00966-1915
Phone
(787) 782-2424
Fax
(787) 782-2430
NPI assigned
Oct 2, 2006
Last updated
Jul 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Authorized official

Name
Alejandro Perez, MDNPI 1821183997
Title
President
Phone
(787) 782-2436

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

221 Carr 2
Guaynabo, PR 00966-1915

Mailing address

221 Carr 2
Guaynabo, PR 00966-1915
Phone (787) 782-2424

Other practice location 1

576 Calle Cesar Gonzalez
Suite 502
San Juan, PR 00918-3758
Phone (787) 771-2391

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051102000539 PR Part B Supplier - Clinic/Group Practice 2264450857 Receives reassigned benefits from 3 practitioners
Practice locations: Guaynabo, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1972696649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 CARR 2",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009661915",
            "telephone_number": "787-782-2424",
            "fax_number": "787-782-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 CARR 2",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009661915",
            "telephone_number": "787-782-2424",
            "fax_number": "787-782-2430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "576 Calle Cesar Gonzalez",
            "address_2": "Suite 502",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009183758",
            "country_code": "US",
            "telephone_number": "787-771-2391",
            "fax_number": "787-281-8144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPINE SPORTS AND MANUAL MEDICINE CLINIC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-782-2436",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.