Organization Active NPI

Dr Miguel a. Velasco Medicina Interna-CSP

  • Specialist
  • Mayaguez, PR
National Provider Identifier
1003957853
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
8941 Issued in PR
Legal business name
DR MIGUEL A. VELASCO MEDICINA INTERNA-CSP
Practice address
114 Calle McKinley W
Edif Plaza Yaguez # 207
Mayaguez, PR 00680-3874
Phone
(787) 831-8166
Fax
(787) 805-2122
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Miguel Angel Velasco, M.D.NPI 1245228584
Title
M.D.
Phone
(787) 831-8166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 8941 PR Primary

Addresses

Primary practice location

114 Calle McKinley W
Edif Plaza Yaguez # 207
Mayaguez, PR 00680-3874

Mailing address

PO Box 6517
Mayaguez, PR 00681-6517
Phone (787) 831-8166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080523000495 PR Part B Supplier - Clinic/Group Practice 2264419084 Receives reassigned benefits from 1 practitioner
Practice locations: Mayaguez, PR

National Provider Directory

National Provider Directory

Locations

114 Calle McKinley W
Ste 207
Mayaguez, PR 00680
Phone (787) 831-8166

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003957853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6517",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006816517",
            "telephone_number": "787-831-8166",
            "fax_number": "787-805-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CALLE MCKINLEY W",
            "address_2": "EDIF PLAZA YAGUEZ # 207",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006803874",
            "telephone_number": "787-831-8166",
            "fax_number": "787-805-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MIGUEL A. VELASCO MEDICINA INTERNA-CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VELASCO",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "ANGEL",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "787-831-8166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "8941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.