Individual provider Active NPI

Jose Acevedo, M.D.

  • General Practice Physician
  • Arecibo, PR
National Provider Identifier
1336170950
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
012050 Issued in PR
Practice address
Carr. 638 K6 H0
Bo. Miraflores
Arecibo, PR 00612
Phone
(787) 816-1028
Fax
(787) 816-1028
NPI assigned
Jul 5, 2006
Last updated
Jul 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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 012050 PR Primary

Addresses

Primary practice location

Carr. 638 K6 H0
Bo. Miraflores
Arecibo, PR 00612

Mailing address

PO Box 2512
Arecibo, PR 00613-2512
Phone (787) 816-1028

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
I20121105000460 PR Practitioner - General Practice 8325299100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Bo Miraflores Carr 638 KM
0 Consultorio Medico Dr Jose Acevedo Tacoro
Arecibo, PR 00612-0000
Phone (787) 816-1028

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012050PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J a T Medical Service PSC CurrentSince Aug 11, 2012 Accepting new patients
Policlinica de Familia Factor Inc Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1336170950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2512",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006132512",
            "telephone_number": "787-816-1028",
            "fax_number": "787-816-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 638 K6 H0",
            "address_2": "BO. MIRAFLORES",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-816-1028",
            "fax_number": "787-816-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "012050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.