Individual provider Active NPI

Luis Baez Vallecillo, MD

  • Hematology & Oncology Physician
  • San Juan, PR
National Provider Identifier
1265788855
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
19615 Issued in PR
Practice address
97 Ave de Diego
San Juan, PR 00927-6310
Phone
(939) 545-6353
Fax
(939) 545-6354
NPI assigned
Aug 1, 2012
Last updated
Sep 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19615 PR
Internal Medicine Physician 207R00000X P6580 TX
Hematology & Oncology Physician 207RH0003X 19615 PR Primary

Addresses

Primary practice location

97 Ave de Diego
San Juan, PR 00927-6310

Mailing address

97 Ave de Diego
San Juan, PR 00927-6310
Phone (787) 919-7919

Other practice location 1

10 Calle Acosta
Caguas, PR 00725-2646
Phone (787) 919-7919

Other names 1

  • Luis Baez Vallecillo Other name

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
I20180306001531 PR Practitioner - Hematology/OncologyPractitioner - Internal Medicine 1759523707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
University of Puerto Rico School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

97 Ave de Diego
San Juan, PR 00927-6310
Phone (939) 545-6353

PR 21 Int PR
18 Bo. Monacillos Urbano
San Juan, PR 00927
Phone 78777283005302

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PR Oncology LLC Internal Medicine CurrentSince May 1, 2020 Accepting new patients
Centro de Cancer de la Universidad Internal Medicine CurrentSince Feb 20, 2021 Accepting new patients
Maria del Pilar Fernandez Marti, MD, LLC CurrentSince May 1, 2020 Accepting new patients

Locations

10 Calle Acosta
Caguas, PR 00725
Phone (787) 746-2858

735 Ave Ponce de Leon
Ste 515
San Juan, PR 00917
Phone (787) 274-3387

735 Ave Ponce de Leon
Ste 517
San Juan, PR 00917
Phone (787) 274-3387

97 Ave de Diego
San Juan, PR 00927
Phone (787) 919-7919

Organizations & group practices 3

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 4

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": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1265788855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 AVE DE DIEGO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009276310",
            "telephone_number": "787-919-7919",
            "fax_number": "787-919-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 AVE DE DIEGO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009276310",
            "telephone_number": "939-545-6353",
            "fax_number": "939-545-6354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Calle Acosta",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "007252646",
            "country_code": "US",
            "telephone_number": "787-919-7919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAEZ VALLECILLO",
        "first_name": "LUIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "19615",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P6580",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PR",
            "license": "19615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUIS",
            "last_name": "BAEZ VALLECILLO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.