Individual provider Active NPI

Jose Luis Lebron Velazquez, MD

  • General Practice Physician
  • Guayama, PR
National Provider Identifier
1013503309
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
022129 Issued in PR
Practice address
Calle Francisco G. Bruno #106 Oeste
Guayama, PR 00784
Phone
(787) 553-3655
NPI assigned
Dec 21, 2020
Last updated
Jun 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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 022129 PR Primary

Addresses

Primary practice location

Calle Francisco G. Bruno #106 Oeste
Guayama, PR 00784

Mailing address

Calle Francisco G. Bruno #106 Oeste
Guayama, PR 00784
Phone (787) 553-3655

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
I20220923000684 PR Practitioner - General Practice 3072998293 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022129PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud Familiar Dr. Julio Palmieri Ferri Inc. Current Accepting new patients
Centro de Salud Familiar Dr. Julio Palmieri Ferri Inc. CurrentSince Sep 8, 2022 Accepting new patients

Locations

46 Calle Morse
Arroyo, PR 00714

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1013503309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE FRANCISCO G. BRUNO #106 OESTE",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-553-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE FRANCISCO G. BRUNO #106 OESTE",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-553-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBRON VELAZQUEZ",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-21",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "022129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guayama, PR

Sources for this page

Verify at the official NPI Registry.