Individual provider Active NPI

Javier Sosa, MD

  • Multi-Specialty Clinic/Center
  • Mayaguez, PR
National Provider Identifier
1205911203
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
14191 Issued in PR
Practice address
Ave. Hostos #410
Suite 101
Mayaguez, PR 00680
Phone
(787) 832-0653
Fax
(787) 832-0653
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 14191 PR Primary

Addresses

Primary practice location

Ave. Hostos #410
Suite 101
Mayaguez, PR 00680

Mailing address

15 Calle Luis Felipe Dessus
Juana Diaz, PR 00795-1501
Phone (787) 832-0653

Other identifiers 4

IdentifierTypeStateIssuer
204349OtherPRPREFERRED HEALTH
601713OtherPRMMM
101203OtherPRMAPFRE
3154OtherPRPMC

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
I20040226000663 PR Practitioner - General Practice 1658267539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Ponce School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hostos Ave 410 St
2 Bo Sabalos
Mayaguez, PR 00680-6353
Phone (787) 832-0653

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Removal of tissue1533

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14191PRMDMulti-Specialty Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Western Hyperbaric Services Multi-Specialty CurrentSince Jul 27, 2005 Accepting new patients
Metropolitan Wound Care Multi-Specialty Past Accepting new patients

Locations

410 Ave Hostos
Ste 2
Mayaguez, PR 00682
Phone (787) 360-3244

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1205911203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CALLE LUIS FELIPE DESSUS",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007951501",
            "telephone_number": "787-832-0653",
            "fax_number": "787-831-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. HOSTOS #410",
            "address_2": "SUITE 101",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-832-0653",
            "fax_number": "787-832-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSA",
        "first_name": "JAVIER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "PR",
            "license": "14191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH",
            "identifier": "204349",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM",
            "identifier": "601713",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAPFRE",
            "identifier": "101203",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMC",
            "identifier": "3154",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.