Individual provider Active NPI

Ivonne Z Jimenez-Velazquez, MD, FACP

  • Geriatric Medicine (Internal Medicine) Physician
  • Carolina, PR
National Provider Identifier
1407974546
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
8243 Issued in PR
Practice address
Plaza Carolina Mall
Suite # 31
Carolina, PR 00983
Phone
(787) 750-8920
Fax
(787) 750-8920
NPI assigned
Mar 27, 2007
Last updated
Apr 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 8243 PR Primary

Addresses

Primary practice location

Plaza Carolina Mall
Suite # 31
Carolina, PR 00983

Mailing address

PO Box 9286
Medicina Interna RCM
Carolina, PR 00988-9286
Phone (787) 751-6034

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
I20031210000523 PR Practitioner - Internal MedicinePractitioner - Geriatric Medicine 6103722186 Reassigns benefits to 2 organizations
Practice locations: Carolina, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
University of Puerto Rico School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 Rd Level
Suite 31
Carolina, PR 00985
Phone (787) 750-8920

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8243PRMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas CurrentSince May 2, 2015 Accepting new patients
Recinto de Ciencias Medicas CurrentSince May 2, 2015 Accepting new patients
Recinto de Ciencias Medicas CurrentSince May 2, 2015 Accepting new patients

Locations

BO Monacillos Ctro Medico
San Juan, PR 00935

Organizations & group practices 3

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1407974546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9286",
            "address_2": "MEDICINA INTERNA RCM",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009889286",
            "telephone_number": "787-751-6034",
            "fax_number": "787-754-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PLAZA CAROLINA MALL",
            "address_2": "SUITE # 31",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00983",
            "telephone_number": "787-750-8920",
            "fax_number": "787-750-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ-VELAZQUEZ",
        "first_name": "IVONNE",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD, FACP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "PR",
            "license": "8243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.