Individual provider Active NPI

Celeste Aida Carrillo, M.D.

  • General Practice Physician
  • Mayaguez, PR
National Provider Identifier
1972835999
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
171742 Issued in PR
Practice address
Carr. 349 KM 2.7 Cerro Las Mesas
Hospital Bella Vista
Mayaguez, PR 00681
Phone
(787) 834-6000
NPI assigned
Feb 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 171742 PR Primary

Addresses

Primary practice location

Carr. 349 KM 2.7 Cerro Las Mesas
Hospital Bella Vista
Mayaguez, PR 00681

Mailing address

P.O. Box 714
Mayaguez, PR 00681-0714
Phone (787) 344-2902

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
I20110113000454 PR Practitioner - General Practice 1658560263 Reassigns benefits to 1 organization
Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centro de Curaciones San Peregrino IncGroup PAC ID 6406013291, 2 clinicians

Practice addresses (Care Compare)

Carr 402 KM 1
Anasco, PR 00610
Phone (787) 608-2512

PO Box
Suite 1938
Anasco, PR 00610

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1998

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
171742PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Curaciones San Peregrino Inc CurrentSince Sep 21, 2016 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1972835999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 714",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006810714",
            "telephone_number": "787-344-2902",
            "fax_number": "787-831-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 349 KM 2.7 CERRO LAS MESAS",
            "address_2": "HOSPITAL BELLA VISTA",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00681",
            "telephone_number": "787-834-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "CELESTE",
        "middle_name": "AIDA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "171742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.