Individual provider Active NPI

Samuel Melendez del Valle, M.D.

  • Primary Care Clinic/Center
  • Mayaguez, PR
National Provider Identifier
1396719548
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
10288 Issued in PR
Practice address
Carr 2
Ave. Hostos 770 Suite 205
Mayaguez, PR 00682-6353
Phone
(787) 831-3845
Fax
(787) 831-3845
NPI assigned
Feb 15, 2006
Last updated
May 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 10288 PR Primary

Addresses

Primary practice location

Carr 2
Ave. Hostos 770 Suite 205
Mayaguez, PR 00682-6353

Mailing address

PO Box 250
Mayaguez, PR 00681-0250
Phone (787) 831-3845

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
I20110412001026 PR Practitioner - Internal Medicine 6901858836 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10288PRMDPrimary Care Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Samuel Melendez Internal Medicine Services PSC Primary Care CurrentSince Dec 9, 2009 Accepting new patients

Locations

770 Ave Hostos
Ste 301
Mayaguez, PR 00682
Phone (787) 430-5636

770 Ave Hostos
Ste 205
Mayaguez, PR 00682
Phone (787) 831-3845

Organizations & group practices 1

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1396719548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006810250",
            "telephone_number": "787-831-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 2",
            "address_2": "AVE. HOSTOS 770 SUITE 205",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006826353",
            "telephone_number": "787-831-3845",
            "fax_number": "787-831-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ DEL VALLE",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PR",
            "license": "10288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.