Individual provider Active NPI

Carmen Lizzette Vargas, MD

  • General Practice Physician
  • Boqueron, PR
National Provider Identifier
1033190848
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9237 Issued in PR
Practice address
#40 Calle Luis Munoz Rivera
Boqueron, PR 00622-0309
Phone
(787) 254-2021
Fax
(787) 254-6180
NPI assigned
Nov 9, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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 9237 PR Primary

Addresses

Primary practice location

#40 Calle Luis Munoz Rivera
Boqueron, PR 00622-0309

Mailing address

PO Box 309
Boqueron, PR 00622-0309
Phone (787) 254-4598

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
I20031229000497 PR Practitioner - General Practice 4880592815 Practice locations: Boqueron, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40 Calle Luis Munoz Rivera
Box 309
Boqueron, PR 00622-0309

PO Box
Suite 309
Boqueron, PR 00622-0309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9237PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Servicios Medicos Las Marias Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1033190848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "BOQUERON",
            "state": "PR",
            "postal_code": "006220309",
            "telephone_number": "787-254-4598",
            "fax_number": "787-254-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#40 CALLE LUIS MUNOZ RIVERA",
            "city": "BOQUERON",
            "state": "PR",
            "postal_code": "006220309",
            "telephone_number": "787-254-2021",
            "fax_number": "787-254-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "CARMEN",
        "middle_name": "LIZZETTE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boqueron, PR

Sources for this page

Verify at the official NPI Registry.