Individual provider Active NPI

Vanessa Reyes Polanco

  • General Practice Physician
  • Caguas, PR
National Provider Identifier
1306819446
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15968 Issued in PR
Practice address
Luis Munos Marin Av. 4980
Caguas, PR 00726
Phone
(787) 653-3434
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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 15968 PR Primary

Addresses

Primary practice location

Luis Munos Marin Av. 4980
Caguas, PR 00726

Mailing address

St. 5 H 20 Urb. Teresita
Bayamon, PR 00961
Phone (787) 459-2199

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
I20060713000123 PR Practitioner - General PracticePractitioner - Emergency Medicine 0547273674 Reassigns benefits to 4 organizations

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

Practice addresses (Care Compare)

Marginal Santa Cruz
17 Urb Santa Cruz
Bayamon, PR 00961-6706
Phone (787) 780-1273

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Foundation of Puerto Rico, Inc. CurrentSince Aug 1, 2015 Accepting new patients
CDT GMSP, Inc Current Accepting new patients
Community Health Foundation of Puerto Rico, Inc. General Practice CurrentSince Aug 1, 2015 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Jun 10, 2012 Accepting new patients
Cooperativa de Facultad Medica Sanacoop CurrentSince Aug 1, 2015 Accepting new patients
Centro Medico del Turabo Inc General Practice CurrentSince Jun 10, 2012 Accepting new patients
CDT GMSP Inc CurrentSince Apr 6, 2014 Accepting new patients
CDT G.M,S.P., Inc General Practice CurrentSince Apr 6, 2014 Accepting new patients

Locations

B7 Calle Santa Cruz
Bayamon, PR 00961
Phone (787) 780-9191

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

Organizations & group practices 8

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1306819446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ST. 5 H 20 URB. TERESITA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-459-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LUIS MUNOS MARIN AV. 4980",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00726",
            "telephone_number": "787-653-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES POLANCO",
        "first_name": "VANESSA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.