Individual provider Active NPI

Joshuan Valentin Collazo, MD

  • General Practice Physician
  • Mayaguez, PR
National Provider Identifier
1124919261
Registry record updated Oct 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
24688 Issued in PR
Practice address
HC 4 Box 42601
Mayaguez, PR 00680-9705
Phone
(787) 538-7616
NPI assigned
Jul 15, 2025
Reactivated
Oct 9, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 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 24688 PR Primary

Addresses

Primary practice location

HC 4 Box 42601
Mayaguez, PR 00680-9705

Mailing address

HC 4 Box 42601
Mayaguez, PR 00680-9705
Phone (787) 538-7616

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
I20251209003136 PR Practitioner - General Practice 5597259465 Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centro de Salud de Lares IncGroup PAC ID 0840272985, shared by 4 NPIs, 32 clinicians

Practice addresses (Care Compare)

PO Box
Suite 379
Lares, PR 00669-0379

Hospital & facility affiliations

  • Hospicio En El Hogar Fe Y Esperanza de Puerto Rico Hospice, Manati, PR, CCN 401504
  • Hospital Perea Hospital, Mayaguez, PR, CCN 400123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24688PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare Medical Services LLC General Practice CurrentSince Jul 22, 2025 Accepting new patients

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": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760140800000",
    "number": "1124919261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 4 BOX 42601",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006809705",
            "telephone_number": "787-538-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 4 BOX 42601",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006809705",
            "telephone_number": "787-538-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTIN COLLAZO",
        "first_name": "JOSHUAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-10-11",
        "certification_date": "2025-10-11",
        "deactivation_date": "2025-09-18",
        "reactivation_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.