Individual provider Active NPI

Juan Gabriel Velazquez Stuart, MD

  • General Practice Physician
  • Humacao, PR
National Provider Identifier
1083295786
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
24281 Issued in PR
Practice address
355 Ave Font Martelo
Humacao, PR 00791-3249
Phone
(787) 852-0768
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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 24281 PR Primary

Addresses

Primary practice location

355 Ave Font Martelo
Humacao, PR 00791-3249

Mailing address

Urb. Enramada Camino de Lirios G21
Bayamon, PR 00961

Other practice location 1

Urb. Enramada Camino de Lirios G21
Bayamon, PR 00961
Phone (787) 972-4183

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
I20250415003878 PR Practitioner - General Practice 0446775175 Reassigns benefits to 1 organization
Practice locations: Juncos, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
1G Medical LLC General Practice CurrentSince Apr 1, 2025 Accepting new patients

Locations

355 Calle Font Martelo
Humacao, PR 00791
Phone (787) 587-4266

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1083295786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. ENRAMADA CAMINO DE LIRIOS G21",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 AVE FONT MARTELO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007913249",
            "telephone_number": "787-852-0768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Urb. Enramada Camino de Lirios G21",
            "address_purpose": "LOCATION",
            "city": "Bayamon",
            "state": "PR",
            "postal_code": "00961",
            "country_code": "US",
            "telephone_number": "787-972-4183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELAZQUEZ STUART",
        "first_name": "JUAN",
        "middle_name": "GABRIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.