Organization Active NPI

Digestive Diseases Associates PSC

  • Specialist
  • San Juan, PR
National Provider Identifier
1982753737
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9101 Issued in PR
Legal business name
DIGESTIVE DISEASES ASSOCIATES PSC
Practice address
1431 Ave Ponce de Leon
Suite 402
San Juan, PR 00907-4026
Phone
(787) 723-9595
Fax
(787) 723-8051
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Authorized official

Name
Adelaida Gely-Mauras
Title
Office Manager
Phone
(787) 723-9595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 9101 PR Primary

Addresses

Primary practice location

1431 Ave Ponce de Leon
Suite 402
San Juan, PR 00907-4026

Mailing address

1431 Ave Ponce de Leon
Suite 402
San Juan, PR 00907-4026
Phone (787) 723-9595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130111000047 PR Part B Supplier - Clinic/Group Practice 0143473694 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

1431 Ave Ponce de Leon
Ste 402
San Juan, PR 00907
Phone (787) 723-9595

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1982753737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 AVE PONCE DE LEON",
            "address_2": "SUITE 402",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009074026",
            "telephone_number": "787-723-9595",
            "fax_number": "787-723-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 AVE PONCE DE LEON",
            "address_2": "SUITE 402",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009074026",
            "telephone_number": "787-723-9595",
            "fax_number": "787-723-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISEASES ASSOCIATES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "GELY-MAURAS",
        "authorized_official_first_name": "ADELAIDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "787-723-9595"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "9101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.