Lidgia R Vives Castro, M.D.
Individual provider Active NPI Neurology Physician · Carolina, PR
NPI 1306922976 · NPPES record last updated Nov 18, 2022
Key facts
- NPI
- 1306922976
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- 11425 (PR)
- Practice address
- Antiguo Edificio Jesus T Pinero 80100 Esquina Molinillo
Carolina, PR 00986 - Phone
- (787) 626-3322
- NPI assigned
- Oct 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- University of Puerto Rico School of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Urb Reparto Metropolitano 1122
5 Suite 2
San Juan, PR 00921
Phone (939) 312-4696
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220801003336 | PR | Practitioner - Neurology | 4486545316 |
Reassigns benefits to 1 organization Practice locations: San Juan, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11425 | PR | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospitalist Medical Services, PSC | Current |
Accepting new patients | |
| Hospitalist Medical Services, PSC | Current |
Accepting new patients | |
| Recinto de Ciencias Medicas | Past | Accepting new patients | |
| Memorial Hospital at Gulfport | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 15664 | MS | |
| Vascular Neurology Physician | 2084V0102X | 11425 | PR | |
| Neurology Physician | 2084N0400X | 11425 | PR | Yes |
Addresses
Primary practice location
Antiguo Edificio Jesus T Pinero 80100 Esquina Molinillo
Carolina, PR 00986
Mailing address
Urb. J Caparra
Calle 1 B21
Bayamon, PR 00959
Phone (939) 260-6861
Other practice location 1
1213 Broad Ave Ste 3
Gulfport, MS 39501-2475
Phone (228) 867-9797
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PM412 | Other | PR | MEDICARE |
| 039304700 | Medicaid | PR |
Other names
- Dr. Lidgia R Vives
Other providers in Carolina, PR
- Vimar Therapy Group Inc
- Vimar Therapy Group, Inc.
- Amelia V. Vinas
- Vitass International, LLC
- Enriqueta Vivas
- Mayte Luciele Vizcarrondo
- Ramon A Vizcarrondo
- Wal-Mart Puerto Rico Inc
- Wal-Mart Puerto Rico Inc
- Wal-Mart Puerto Rico Inc
All providers in Carolina, PR · Neurology Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.