Southwest Oto and Head & Neck Surgery,psc
NPI 1891104188ActiveOrganization· Otolaryngology, Plastic Surgery within the Head & Neck· Ponce, PR
Otolaryngology, Plastic Surgery within the Head & Neck in Ponce, Puerto Rico, registered in NPPES in August 2014. The authorized official on file is Edgar Domenech Fagundo, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1891104188 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 12, 2014 |
| Last updated in NPPES | Aug 12, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Otolaryngology, Plastic Surgery within the Head & Neck Primary | 207YX0007X | 13247 | PR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (PR) |
|---|
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