Individual provider Active NPI

Jaime E Diaz Vicente, D.M.D

  • Dentist
  • Cayey, PR
National Provider Identifier
1265541957
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1532 Issued in PR
Practice address
58 Calle Jose Celso Barbosa S
Cayey, PR 00736-4727
Phone
(787) 263-1313
Fax
(787) 263-4597
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1532 PR Primary

Addresses

Primary practice location

58 Calle Jose Celso Barbosa S
Cayey, PR 00736-4727

Mailing address

PO Box 373068
Cayey, PR 00737-3068
Phone (787) 263-1313

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160419002626 PR Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7214235548

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1532PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265541957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 373068",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "007373068",
            "telephone_number": "787-263-1313",
            "fax_number": "787-263-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 CALLE JOSE CELSO BARBOSA S",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "007364727",
            "telephone_number": "787-263-1313",
            "fax_number": "787-263-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ VICENTE",
        "first_name": "JAIME",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayey, PR

Sources for this page

Verify at the official NPI Registry.