Individual provider Active NPI

Nestor L. Olivo-Crespo, M.D.

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1285619775
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
012474 Issued in PR
Practice address
1251 Ave Americo Miranda
Reparto Metropolitano
San Juan, PR 00921-1619
Phone
(787) 781-7295
NPI assigned
Dec 7, 2005
Last updated
Feb 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 012474 PR Primary

Addresses

Primary practice location

1251 Ave Americo Miranda
Reparto Metropolitano
San Juan, PR 00921-1619

Mailing address

PO Box 651
Vega Alta, PR 00692-0651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140904000615 TX Practitioner - Internal Medicine 3072500560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

210 Hospital Cir
Choctaw, MS 39350-6781
Phone (601) 389-4500

210 Hospital Circle
Choctaw, MS 39350-6781

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012474PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Band of Choctaw Indians CurrentSince Apr 6, 2018 Accepting new patients
Mississippi Band of Choctaw Indians CurrentSince Apr 6, 2018 Accepting new patients
Mississippi Band of Choctaw Indians Current Accepting new patients
Mississippi Band of Choctaw Indians Past Accepting new patients

Locations

210 Hospital Cir
Choctaw, MS 39350
Phone (601) 389-4500

Organizations & group practices 4

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1285619775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 651",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006920651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 AVE AMERICO MIRANDA",
            "address_2": "REPARTO METROPOLITANO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009211619",
            "telephone_number": "787-781-7295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVO-CRESPO",
        "first_name": "NESTOR",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "012474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.