Individual provider Active NPI

Melissa M Wheeler, M.D.

  • Family Medicine Physician
  • Guaynabo, PR
National Provider Identifier
1063543312
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16373 Issued in PR
Practice address
17 Calle San Jose Apt 503
Fountainblue Village
Guaynabo, PR 00969-4734
Phone
(787) 447-6646
NPI assigned
Mar 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16373 PR Primary

Addresses

Primary practice location

17 Calle San Jose Apt 503
Fountainblue Village
Guaynabo, PR 00969-4734

Mailing address

PO Box 71325
Suite 99
San Juan, PR 00936-8425
Phone (787) 447-6646

Other identifiers 1

IdentifierTypeStateIssuer
4041109OtherPRDRIVERS LICENCE

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
I20070911000602 PR Practitioner - Family Practice 2961595616 Practice locations: Caguas, 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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063543312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71325",
            "address_2": "SUITE 99",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009368425",
            "telephone_number": "787-447-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CALLE SAN JOSE APT 503",
            "address_2": "FOUNTAINBLUE VILLAGE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694734",
            "telephone_number": "787-447-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "MELISSA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "16373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENCE",
            "identifier": "4041109",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.