Individual provider Active NPI

Carmen Velazquez

  • Physical Medicine & Rehabilitation Physician
  • Guaynabo, PR
National Provider Identifier
1104902162
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
13910 Issued in PR
Practice address
101 Ave San Patricio
Maramar Plaza Suite 1150
Guaynabo, PR 00968-2645
Phone
(787) 793-2623
Fax
(787) 793-2700
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 13910 PR Primary

Addresses

Primary practice location

101 Ave San Patricio
Maramar Plaza Suite 1150
Guaynabo, PR 00968-2645

Mailing address

101 Ave San Patricio
Maramar Plaza Suite 1150
Guaynabo, PR 00968-2645
Phone (787) 793-2623

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
I20070926001131 PR Practitioner - Physical Medicine and Rehabilitation 0648365304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Puerto Rico School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Patricio Physical Rehabilitation Center PSCGroup PAC ID 5799840484, 2 clinicians

Practice addresses (Care Compare)

101 Ave San Patricio
Suite 1150
Guaynabo, PR 00968-2647
Phone (787) 793-2623

Hospital & facility affiliations

  • Auxilio Mutuo Hospital Hospital, San Juan, PR, CCN 400016
  • Presbyterian Community Hospital Hospital, San Juan, PR, CCN 400001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13910PRMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Patricio Physical Rehabilitation Center PSC CurrentSince Jan 15, 2009 Accepting new patients

Locations

101 Ave San Patricio
Ste 1150
Guaynabo, PR 00968
Phone (787) 793-2623

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1104902162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AVE SAN PATRICIO",
            "address_2": "MARAMAR PLAZA SUITE 1150",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009682645",
            "telephone_number": "787-793-2623",
            "fax_number": "787-793-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AVE SAN PATRICIO",
            "address_2": "MARAMAR PLAZA SUITE 1150",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009682645",
            "telephone_number": "787-793-2623",
            "fax_number": "787-793-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "CARMEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PR",
            "license": "13910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.