Individual provider Active NPI

John N Velazquez Rodriguez, M.D.

  • General Practice Physician
  • Fajardo, PR
National Provider Identifier
1205854569
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15213 Issued in PR
Practice address
404 Ave General Valero
Fajardo, PR 00738-3998
Phone
(787) 585-3997
NPI assigned
Jul 17, 2006
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 15213 PR Primary

Addresses

Primary practice location

404 Ave General Valero
Fajardo, PR 00738-3998

Mailing address

Torre San Pablo del Este
410 Ave General Valero
Fajardo, PR 00738-3949
Phone (787) 585-3997

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
I20040202000004 PR Practitioner - General Practice 2769385103 Reassigns benefits to 3 organizations
Practice locations: Fajardo, PR; Rio Grande, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15213PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gobierno Municipal de Juncos CurrentSince Sep 28, 2025 Accepting new patients
Municipio de Juncos CurrentSince Sep 28, 2025 Accepting new patients
Cirugia General Y Periferovascular del Noreste, CSP PastSince Sep 23, 2024 Accepting new patients
Hospital General San Carlos,Inc. Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1205854569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TORRE SAN PABLO DEL ESTE",
            "address_2": "410 AVE GENERAL VALERO",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007383949",
            "telephone_number": "787-585-3997",
            "fax_number": "787-203-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 AVE GENERAL VALERO",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007383998",
            "telephone_number": "787-585-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ RODRIGUEZ",
        "first_name": "JOHN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

Verify at the official NPI Registry.