Western PR Neurological Clinic CSP

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

16784 Issued in PR

Legal business name

WESTERN PR NEUROLOGICAL CLINIC CSP

Practice address

Medical Emporium II Carr #2, Nostos Avenue Ky. 157
Suite 3a
Mayaguez, PR 00680

Phone

(787) 265-6622

Fax

(787) 265-6622

NPI assigned

Oct 9, 2013

Organization subpart

No

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

Authorized official

Name

Jose Alberto Acevedo, M.D.NPI 1447451836

Title

Ceo

Phone

(787) 447-8819

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jose Alberto Acevedo, MD

  • Neurology Physician
  • Mayaguez, PR
  • NPI 1447451836
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1265869168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#42 COSTA BRAVA STREET",
            "address_2": "URB. LAS VISTAS",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "00623",
            "telephone_number": "787-265-6622",
            "fax_number": "787-265-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL EMPORIUM II CARR #2, NOSTOS AVENUE KY. 157",
            "address_2": "SUITE 3A",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-265-6622",
            "fax_number": "787-265-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN PR NEUROLOGICAL CLINIC CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "787-447-8819",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "PR",
            "license": "16784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Western Imaging Services, P.S.C
• Western Medical Alliance Co
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• Western Neonatal Services, CSP
• Western Pathology and Citology Lab
• Western Radiosonics, Inc.
• Western Radiotherapy Cancer Center
• Western Sleep Clinic, CSP
• Westside Dermatology LLC
• X Press Medical Equipment

• Medical Specialty Clinic/Center in Mayaguez, PR
• Providers in Mayaguez, PR by specialty
• Medical Specialty Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.