Active NPI
Rafael A Justiniano, M.D.
- Vascular Surgery Physician
- Mayaguez, PR
National Provider Identifier
1073589792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 4978
- Practice address
- Calle Mendez Vigo 109 Este
Mayaguez, PR 00681-3049 - Phone
- (787) 834-7740
- Fax
- (787) 833-0868
- NPI assigned
- Feb 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 4978 | PR | Primary |
Addresses
Primary practice location
Calle Mendez Vigo 109 Este
Mayaguez, PR 00681-3049
Mailing address
714 Calle Azorin
Mayaguez, PR 00682-6644
Phone (787) 834-4127
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4978 | PR | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital de la Concepcion Inc | Past | Accepting new patients | |
| Laboratorio Vascular No Invasivo | Vascular Surgery | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- San German, PR
- NPI 1366484594
-
- Clinical Medical Laboratory
- Mayaguez, PR
- NPI 1427166230
Vascular Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492387200000",
"number": "1073589792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 CALLE AZORIN",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "006826644",
"telephone_number": "787-834-4127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE MENDEZ VIGO 109 ESTE",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "006813049",
"telephone_number": "787-834-7740",
"fax_number": "787-833-0868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUSTINIANO",
"first_name": "RAFAEL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-23",
"last_updated": "2017-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "PR",
"license": "4978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mayaguez, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.