Julio E Vergne Maldonado, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

015422 Issued in PR

Practice address

Carolina Shopping Court, Suite 201 a
Carolina, PR 00985

Phone

(787) 767-8758

Fax

(844) 759-2966

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Physician H.M.O. Inc.

  • Intermediate Emergency Medical Technician
  • San Juan, PR
  • NPI 1730481649
  Medicare reassignment NPD

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1154438158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193044",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009193044",
            "telephone_number": "787-945-1472",
            "fax_number": "787-250-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAROLINA SHOPPING COURT, SUITE 201 A",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-767-8758",
            "fax_number": "844-759-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGNE MALDONADO",
        "first_name": "JULIO",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "015422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38124000",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paola Velez
• Mayra Vera, D.MD.
• Mildred Vera, PHD
• Joyce Verdejo, LND
• Mark Anthony Vergara-Gomez, M.D.
• Maria Viana, M.D.
• Aris Daniel Vidal, RN, SRNA
• Marina Gabrielle Vidal
• Fabian Andres Vidarte Quintana, MD
• Fernando Viejo, 333

• General Practice Physician in Carolina, PR
• Providers in Carolina, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.