NPIMap

Organization Active NPI

Juan C. Velasco Cervilla MD CSP

  • Internal Medicine Physician
  • Yauco, PR
National Provider Identifier
1275537763
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10541 Issued in PR
Legal business name
JUAN C. VELASCO CERVILLA MD CSP
Practice address
40 - 25 De Julio
Yauco, PR 00698-0000
Phone
(787) 267-2811
Fax
(787) 267-1964
NPI assigned
Jun 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Dr. Juan Carlos Velasco- Cervilla, M.D.NPI 1659305225
Title
President
Phone
(787) 267-2811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 10541 PR Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 15870 PR

Addresses

Primary practice location

40 - 25 De Julio
Yauco, PR 00698-0000

Mailing address

PO Box 3004
Yauco, PR 00698-3004
Phone (787) 267-2811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071219000178 PR Part B Supplier - Clinic/Group Practice 7911097621 Receives reassigned benefits from 2 practitioners
Practice locations: Yauco, PR

National Provider Directory

National Provider Directory

Locations

40 Calle 25 de Julio
Yauco, PR 00698
Phone (787) 267-2811

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1275537763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3004",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006983004",
            "telephone_number": "787-267-2811",
            "fax_number": "787-267-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 - 25 DE JULIO",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006980000",
            "telephone_number": "787-267-2811",
            "fax_number": "787-267-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN C. VELASCO CERVILLA MD CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "VELASCO- CERVILLA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-267-2811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "10541",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "15870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yauco, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.