Individual provider Active NPI

Milagros Rivera Vazquez, M.D.

  • General Practice Physician
  • Guayama, PR
National Provider Identifier
1346432580
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
11190 Issued in PR
Practice address
Complejo Correccional Guayama
Guayama, PR 00784
Phone
(787) 864-3114
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 11190 PR Primary

Addresses

Primary practice location

Complejo Correccional Guayama
Guayama, PR 00784

Mailing address

O13 Calle Q
Urb. Jardines de Lafayette
Arroyo, PR 00714-2225
Phone (787) 866-9334

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
I20210928003840 PR Practitioner - General Practice 4688071905 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11190FLMDClinical Social Worker
11190PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administracion de Servicios de Salud Mental Y Contra la Adiccion CurrentSince Apr 15, 2024 Accepting new patients
Administracion de Servicios de Salud Mental Y Contra la Adiccion Single Specialty CurrentSince Apr 15, 2024 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.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1346432580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "O13 CALLE Q",
            "address_2": "URB. JARDINES DE LAFAYETTE",
            "city": "ARROYO",
            "state": "PR",
            "postal_code": "007142225",
            "telephone_number": "787-866-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COMPLEJO CORRECCIONAL GUAYAMA",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-864-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA VAZQUEZ",
        "first_name": "MILAGROS",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "11190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guayama, PR

Sources for this page

Verify at the official NPI Registry.