NPIMap

Individual provider Active NPI

Rey William Carvajal, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Miami, FL
National Provider Identifier
1245764976
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
84778-20 Issued in WI
Practice address
9555 SW 162ND Ave
Miami, FL 33196-6408
Phone
(304) 597-8646
Fax
(786) 533-9545
NPI assigned
Apr 19, 2017
Last updated
Jan 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 84778-20 WI Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X ME148498 FL

Addresses

Primary practice location

9555 SW 162ND Ave
Miami, FL 33196-6408

Mailing address

1800 Lawrence Dr
De Pere, WI 54115-9108
Phone (920) 983-3220

Other identifiers 2

IdentifierTypeStateIssuer
4301512799OtherMILICENSE
84778-20OtherWILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241030001623 WI Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 1355610171 Reassigns benefits to 2 organizations
I20241120002900 MI Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 1355610171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, shared by 10 NPIs, 685 clinicians
Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, shared by 12 NPIs, 217 clinicians

Practice addresses (Care Compare)

1800 Lawrence Dr
De Pere, WI 54115-9108
Phone (920) 983-3220

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone (906) 776-9040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Oct 22, 2024 Accepting new patients
Oconto Hospital & Medical Center, Inc. Hospice and Palliative Medicine CurrentSince Dec 6, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc Hospice and Palliative Medicine CurrentSince Dec 6, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc Hospice and Palliative Medicine Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Dec 6, 2024 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

1800 Lawrence Dr
De Pere, WI 54115
Phone (920) 983-3220

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: rcarvajal1027187@direct.emplifyhealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1245764976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 LAWRENCE DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159108",
            "telephone_number": "920-983-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 SW 162ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331966408",
            "telephone_number": "304-597-8646",
            "fax_number": "786-533-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARVAJAL",
        "first_name": "REY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "WI",
            "license": "84778-20",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME148498",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301512799",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "84778-20",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.