Individual provider Active NPI

Juan Antonio Perez Vazquez Jr., MD

  • General Practice Physician
  • Vega Baja, PR
National Provider Identifier
1114090024
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
6765 Issued in PR
Practice address
46 JJ Acosta
Vega Baja, PR 00693
Phone
(787) 858-6208
Fax
(787) 858-6208
NPI assigned
Nov 16, 2006
Last updated
Oct 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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 6765 PR Primary

Addresses

Primary practice location

46 JJ Acosta
Vega Baja, PR 00693

Mailing address

PO Box 4644
Vega Baja, PR 00694-4644
Phone (787) 858-6208

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
I20131210001427 PR Practitioner - General Practice 2769621952 Practice locations: Vega Baja, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Calle Padilla Davila
Vega Baja, PR 00693-4379
Phone (787) 858-6208

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1114090024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4644",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006944644",
            "telephone_number": "787-858-6208",
            "fax_number": "787-858-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 JJ ACOSTA",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00693",
            "telephone_number": "787-858-6208",
            "fax_number": "787-858-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ VAZQUEZ",
        "first_name": "JUAN",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "6765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

Verify at the official NPI Registry.