Individual provider Active NPI

Irelis Villegas Fiol

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1053917807
Registry record updated Dec 29, 2020
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Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22103 Issued in PR
Practice address
Carr 859 KM 1.9 Bo. Santa Cruz
Carolina, PR 00987
Phone
(786) 731-1611
NPI assigned
Dec 8, 2020
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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 22103 PR Primary

Addresses

Primary practice location

Carr 859 KM 1.9 Bo. Santa Cruz
Carolina, PR 00987

Mailing address

HC 1 Box 11047
Carolina, PR 00987-9652
Phone (786) 731-1611

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
I20210303000411 PR Practitioner - General Practice 0941616783 Practice locations: Bayamon, PR; Dorado, PR

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1053917807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 11047",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009879652",
            "telephone_number": "786-731-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 859 KM 1.9 BO. SANTA CRUZ",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "786-731-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLEGAS FIOL",
        "first_name": "IRELIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.