Individual provider Active NPI

Rafael A Justiniano, M.D.

  • Vascular Surgery Physician
  • Mayaguez, PR
National Provider Identifier
1073589792
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4978 Issued in PR
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

Updated by the provider on Apr 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
4978PRMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.