Individual provider Active NPI

Elba Velazquez, MD

  • General Practice Physician
  • Penuelas, PR
National Provider Identifier
1285619536
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
10420 Issued in PR
Practice address
959 Calle Munoz Rivera
Munoz Rivera 959
Penuelas, PR 00624-2022
Phone
(787) 836-7603
NPI assigned
Dec 9, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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
General Practice Physician 208D00000X 10420 PR Primary

Addresses

Primary practice location

959 Calle Munoz Rivera
Munoz Rivera 959
Penuelas, PR 00624-2022

Mailing address

PO Box 68
Penuelas, PR 00624-0068
Phone (787) 836-8522

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
I20230203002695 PR Practitioner - General Practice 4183096910 Practice locations: Penuelas, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10420PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evf Medical Service Inc General Practice CurrentSince May 16, 2022 Accepting new patients

Locations

959 Calle Munoz Rivera
Penuelas, PR 00624
Phone (787) 651-6714

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285619536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "PENUELAS",
            "state": "PR",
            "postal_code": "006240068",
            "telephone_number": "787-836-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 CALLE MUNOZ RIVERA",
            "address_2": "MUNOZ RIVERA 959",
            "city": "PENUELAS",
            "state": "PR",
            "postal_code": "006242022",
            "telephone_number": "787-836-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "ELBA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "10420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penuelas, PR

Sources for this page

Verify at the official NPI Registry.