Organization Active NPI

Quiropractica del Encanto, CSP

  • Chiropractor
  • San Juan, PR
National Provider Identifier
1306199062
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
507 Issued in PR
Legal business name
QUIROPRACTICA DEL ENCANTO, CSP
Practice address
1751 Ave Paz Granela
Urb Santiago Iglesias
San Juan, PR 00921-3630
Phone
(787) 200-9144
Fax
(789) 200-9108
NPI assigned
Oct 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Authorized official

Name
Dr. Edwin Javier Velez-Correa, DC
Title
Doctor
Phone
(789) 500-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 507 PR Primary

Addresses

Primary practice location

1751 Ave Paz Granela
Urb Santiago Iglesias
San Juan, PR 00921-3630

Mailing address

1751 Ave Paz Granela
Urb Santiago Iglesias
San Juan, PR 00921-3630
Phone (787) 200-9144

Other identifiers 1

IdentifierTypeStateIssuer
037606900MedicaidPR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130211000242 PR Part B Supplier - Clinic/Group Practice 0042464554 Receives reassigned benefits from 2 practitioners
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

1751 Ave Paz Granela
San Juan, PR 00921
Phone (787) 200-9144

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": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1306199062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 AVE PAZ GRANELA",
            "address_2": "URB SANTIAGO IGLESIAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213630",
            "telephone_number": "787-200-9144",
            "fax_number": "789-200-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 AVE PAZ GRANELA",
            "address_2": "URB SANTIAGO IGLESIAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213630",
            "telephone_number": "787-200-9144",
            "fax_number": "789-200-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUIROPRACTICA DEL ENCANTO, CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-18",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "VELEZ-CORREA",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "JAVIER",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "789-500-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037606900",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.