Individual provider Active NPI

Randy Omar Marquez Caban, M.D.

  • General Practice Physician
  • Vega Baja, PR
National Provider Identifier
1275572000
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16270 Issued in PR
Practice address
Bo Pugnado Adentro Carr 155 KM 58.5
Vega Baja, PR 00693-9767
Phone
(787) 969-0020
NPI assigned
Jun 6, 2006
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16270 PR Primary

Addresses

Primary practice location

Bo Pugnado Adentro Carr 155 KM 58.5
Vega Baja, PR 00693-9767

Mailing address

HC 1 Box 27078
Vega Baja, PR 00693-9767

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
I20060505000307 PR Practitioner - General Practice 7113938143 Reassigns benefits to 1 organization
Practice locations: Vega Baja, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Medical and Wound Care CenterGroup PAC ID 3779729702, 2 clinicians

Practice addresses (Care Compare)

3 Carr
155 Km585
Vega Baja, PR 00693-5243
Phone (787) 969-0020

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16270PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Medical & Wound Care Center CurrentSince Feb 25, 2013 Accepting new patients
Advanced Wound Healing Corp. Past Accepting new patients
Metropolitan Wound Care Past Accepting new patients

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 1

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1275572000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 27078",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006939767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO PUGNADO ADENTRO CARR 155 KM 58.5",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006939767",
            "telephone_number": "787-969-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ CABAN",
        "first_name": "RANDY",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

Verify at the official NPI Registry.