Individual provider Active NPI

Rosa Tania Vasquez Castellanos, MD

  • General Practice Physician
  • Moca, PR
National Provider Identifier
1396398079
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
21471 Issued in PR
Practice address
Carretera 420 KM 4.4
Bo Plata
Moca, PR 00676
Phone
(787) 951-8978
Fax
(787) 818-0900
NPI assigned
Jul 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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 21471 PR Primary

Addresses

Primary practice location

Carretera 420 KM 4.4
Bo Plata
Moca, PR 00676

Mailing address

PO Box 367
San Sebastian, PR 00685-0367
Phone (787) 951-8978

Other identifiers 1

IdentifierTypeStateIssuer
4386909OtherPRPR LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21471PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1396398079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006850367",
            "telephone_number": "787-951-8978",
            "fax_number": "787-818-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 420 KM 4.4",
            "address_2": "BO PLATA",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "00676",
            "telephone_number": "787-951-8978",
            "fax_number": "787-818-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ CASTELLANOS",
        "first_name": "ROSA",
        "middle_name": "TANIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PR LICENSE NUMBER",
            "identifier": "4386909",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moca, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.