Individual provider Active NPI

Wellington Vargas Valdez, M.D.

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1073586053
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
10691 Issued in PR
Practice address
PMB 108 2135
Suite 15 Carr 2
Bayamon, PR 00959-5259
Phone
(787) 779-0122
NPI assigned
Feb 9, 2006
Last updated
Oct 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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 10691 PR Primary

Addresses

Primary practice location

PMB 108 2135
Suite 15 Carr 2
Bayamon, PR 00959-5259

Mailing address

Bosque del Lago Plaza 8
BC 25
Trujillo Alto, PR 00976-6039
Phone (787) 647-4307

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
I20120309000274 PR Practitioner - General Practice 6204095334 Reassigns benefits to 1 organization
Practice locations: Bayamon, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Puerto Rico Health LLC CurrentSince Sep 24, 2022 Accepting new patients

Locations

200 Ave Orquidea
#V
Bayamon, PR 00959
Phone (787) 779-0122

200 Ave Orquidea
Bayamon, PR 00959
Phone (787) 779-0122

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, 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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1073586053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOSQUE DEL LAGO PLAZA 8",
            "address_2": "BC 25",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009766039",
            "telephone_number": "787-647-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PMB 108 2135",
            "address_2": "SUITE 15 CARR 2",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009595259",
            "telephone_number": "787-779-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS VALDEZ",
        "first_name": "WELLINGTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "10691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.