Individual provider Active NPI

Enrique Raul Maldonado Corchado, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Guaynabo, PR
National Provider Identifier
1972873792
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
Q8103 Issued in TX
Practice address
136 Calle Carazo Ste 3
Guaynabo, PR 00969-6412
Phone
(787) 708-6200
Fax
(787) 708-6228
NPI assigned
Jan 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 258254 MA
Student in an Organized Health Care Education/Training Program 390200000X NY
Endocrinology, Diabetes & Metabolism Physician 207RE0101X Q8103 TX Primary

Addresses

Primary practice location

136 Calle Carazo Ste 3
Guaynabo, PR 00969-6412

Mailing address

PO Box 3972
Guaynabo, PR 00970-3972
Phone (787) 708-6200

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
I20200706001275 PR Practitioner - EndocrinologyPractitioner - Internal Medicine 7416174578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

136 Calle Carazo
Suite 3
Guaynabo, PR 00969-6412
Phone (787) 708-6200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
258254MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guaynabo Endocrinology Center P.S.C. Endocrinology, Diabetes & Metabolism CurrentSince Apr 28, 2020 Accepting new patients

Locations

136 Calle Carazo
Ste 3
Guaynabo, PR 00969
Phone (787) 414-9722

136 Calle Carazo
Guaynabo, PR 00969
Phone (787) 708-6200

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": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1972873792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3972",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009703972",
            "telephone_number": "787-708-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 CALLE CARAZO STE 3",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009696412",
            "telephone_number": "787-708-6200",
            "fax_number": "787-708-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO CORCHADO",
        "first_name": "ENRIQUE",
        "middle_name": "RAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-10",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "258254",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "Q8103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.