Individual provider Active NPI

Mercy J Acosta Vazquez, MD

  • General Practice Physician
  • Mayaguez, PR
National Provider Identifier
1235321936
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17286 Issued in PR
Practice address
65 Villa Soledad
Mayaguez, PR 00680-7135
Phone
(787) 402-8403
NPI assigned
Aug 16, 2007
Last updated
Apr 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2013

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 17286 PR Primary

Addresses

Primary practice location

65 Villa Soledad
Mayaguez, PR 00680-7135

Mailing address

65 Villa Soledad
Mayaguez, PR 00680-7135
Phone (787) 402-8403

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
I20091113000274 PR Practitioner - Geriatric Medicine 3375681265 Reassigns benefits to 1 organization
Practice locations: Mayaguez, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17286PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Yaguez, Inc. CurrentSince Jun 13, 2012 Accepting new patients
Clinica Yaguez, Inc CurrentSince Jun 13, 2012 Accepting new patients

Locations

117 Calle Ramon Valdes
Mayaguez, PR 00680
Phone (787) 832-8445

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, 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": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1235321936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 VILLA SOLEDAD",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006807135",
            "telephone_number": "787-402-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 VILLA SOLEDAD",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006807135",
            "telephone_number": "787-402-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA VAZQUEZ",
        "first_name": "MERCY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.