Individual provider Active NPI

Mary T Chacon Crespo, M.D.

  • General Practice Physician
  • Dorado, PR
National Provider Identifier
1982652111
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15730 Issued in PR
Practice address
Bo. Mameyal 698
Dorado, PR 00646
Phone
(787) 224-0261
NPI assigned
May 4, 2006
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 15730 PR Primary

Addresses

Primary practice location

Bo. Mameyal 698
Dorado, PR 00646

Mailing address

PO Box 1806
Dorado, PR 00646-1806
Phone (787) 224-0261

Other identifiers 1

IdentifierTypeStateIssuer
I36878MedicaidPR

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
I20050730000009 PR Practitioner - General Practice 6406884519 Reassigns benefits to 7 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15730PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Toa Baja, Inc. CurrentSince Jul 25, 2024 Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Salud Integral En la Montana, Inc Current Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Best Medical Options LLC General Practice CurrentSince Mar 23, 2025 Accepting new patients
CDT Centro de Servicios Medicos Integrados Inc. Current Accepting new patients
Salud Integral En la Montana, Inc Current Accepting new patients
Salud Integral En la Montana, Inc. General Practice CurrentSince Oct 1, 2025 Accepting new patients
Salud Integral En la Montana, Inc. General Practice Current Accepting new patients
Metro Toa Baja, Inc. CurrentSince Jul 25, 2024 Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Best Medical Options LLC CurrentSince Mar 23, 2025 Accepting new patients
CDT Centro de Servicios Medicos Integrados, Inc. CurrentSince Mar 24, 2016 Accepting new patients

Locations

59 Calle Santa Cruz
Bayamon, PR 00961
Phone (787) 778-2100

53 Calle Palmeras
Ste 902
San Juan, PR 00901

16 Calle Antonio R Barcelo
Toa Alta, PR 00953
Phone (787) 230-7190

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1982652111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1806",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006461806",
            "telephone_number": "787-224-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO. MAMEYAL 698",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "00646",
            "telephone_number": "787-224-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACON CRESPO",
        "first_name": "MARY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "I36878",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

Verify at the official NPI Registry.