Individual provider Active NPI

Manuel J Vazquez, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1083677223
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
246827 Issued in NY
Practice address
1065 Southern Blvd
Bronx, NY 10459-2417
Phone
(718) 589-2440
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12692 PR
Internal Medicine Physician 207R00000X 246827 NY Primary

Addresses

Primary practice location

1065 Southern Blvd
Bronx, NY 10459-2417

Mailing address

PO Box 5034
Basking Ridge, NJ 07920-5034
Phone (787) 649-8846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20081103000330 NY Practitioner - Internal Medicine 7810895331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Puerto Rico School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urban Health Plan IncGroup PAC ID 3173517281, 158 clinicians

Practice addresses (Care Compare)

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

882 -886 Hunts Point Ave
Bronx, NY 10474-5402
Phone (347) 503-7935

890 Hunts Point Ave
Bronx, NY 10474-5402
Phone (718) 589-2141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12692PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Health Plan, Inc. CurrentSince Jan 24, 2008 Accepting new patients
Urban Health Plan, Inc CurrentSince Jan 24, 2008 Accepting new patients
Urban Health Plan, Inc. Current Accepting new patients
Urban Health Plan, Inc. Current Accepting new patients

Locations

1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600

866 E Tremont Ave
Bronx, NY 10460
Phone (347) 284-0595

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

271 E 138th St
Bronx, NY 10454
Phone (347) 407-7120

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: manuel.vazquezayala@uhp.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GGEFAA/Endpoint/GGEFAA

Organizations & group practices 4

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1083677223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5034",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079205034",
            "telephone_number": "787-649-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417",
            "telephone_number": "718-589-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "MANUEL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12692",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "246827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.