Individual provider Active NPI

Jose P Decastro Vazquez

  • Student in an Organized Health Care Education/Training Program
  • New Orleans, LA
National Provider Identifier
1417692302
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
347223 Issued in LA
Practice address
2021 Perdido St FL 7
New Orleans, LA 70112-1352
Phone
(504) 568-3381
NPI assigned
May 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 347223 LA Primary

Addresses

Primary practice location

2021 Perdido St FL 7
New Orleans, LA 70112-1352

Mailing address

PO Box 7004
Ponce, PR 00732-7004

Other practice location 1

388 Zona Ind Reparada 2
Ponce, PR 00716-2347
Phone (787) 840-2575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20250618003033 LA Order and Referring Only - Diagnostic RadiologyPractitioner - Diagnostic Radiology 6204347941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1417692302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7004",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007327004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 PERDIDO ST FL 7",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701121352",
            "telephone_number": "504-568-3381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "388 Zona Ind Reparada 2",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "007162347",
            "country_code": "US",
            "telephone_number": "787-840-2575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECASTRO VAZQUEZ",
        "first_name": "JOSE",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-04",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": "347223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.