Active NPI
Juan G Santiago Vega, 17561
- General Practice Physician
- Penuelas, PR
National Provider Identifier
1295960268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 17561
- Practice address
- HC03
Box 13437
Penuelas, PR 00624 - Phone
- (787) 836-2216
- NPI assigned
- May 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 17561 | PR | Primary |
Addresses
Primary practice location
HC03
Box 13437
Penuelas, PR 00624
Mailing address
HC03
Box13437
Penuelas, PR 00624
Phone (787) 836-2216
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091231000247 | PR | Practitioner - General Practice | 4082755855 | Practice locations: Canovanas, PR; Penuelas, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17561 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Policlinica del Carmen | General Practice | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261958400000",
"number": "1295960268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC03",
"address_2": "BOX13437",
"city": "PENUELAS",
"state": "PR",
"postal_code": "00624",
"telephone_number": "787-836-2216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HC03",
"address_2": "BOX 13437",
"city": "PENUELAS",
"state": "PR",
"postal_code": "00624",
"telephone_number": "787-836-2216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO VEGA",
"first_name": "JUAN",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "17561",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-20",
"last_updated": "2009-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "17561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penuelas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.