NPIMap

Individual provider Active NPI

Marysol Vicente, MD

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1447880786
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
21645 Issued in PR
Practice address
53-1 Calle 60a
Bayamon, PR 00957-3871
Phone
(787) 242-7101
NPI assigned
Jan 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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 21645 PR Primary

Addresses

Primary practice location

53-1 Calle 60a
Bayamon, PR 00957-3871

Mailing address

HC 2 Box 7147
Barranquitas, PR 00794-9295
Phone (787) 242-7101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200421001342 PR Practitioner - General Practice 1850721564 Reassigns benefits to 6 organizations
Practice locations: Guaynabo, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Integral En la Montana IncGroup PAC ID 8527972827, 64 clinicians

Practice addresses (Care Compare)

Carr 156 Calle Barcelo
Suite 53
Barranquitas, PR 00794-1735
Phone (787) 857-2688

Hospital & facility affiliations

  • Salud Integral En la Montana Inc Home health agency, Naranjito, PR, CCN 407008
  • Nueva Vida de la Salud Home Care Corp Home health agency, Bayamon, PR, CCN 407035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21645PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc General Practice Current Accepting new patients
Salud Integral En la Montana, Inc Current Accepting new patients
Salud Integral En la Montana, Inc. Current Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc General Practice Current Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc. CurrentSince Mar 17, 2021 Accepting new patients
Salud Integral En la Montana, Inc. General Practice Current Accepting new patients
Salud Integral En la Montana, Inc CurrentSince Mar 17, 2021 Accepting new patients

Locations

156 Calle Barcelo
#53
Barranquitas, PR 00794
Phone (787) 857-2688

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 17

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1447880786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 2 BOX 7147",
            "city": "BARRANQUITAS",
            "state": "PR",
            "postal_code": "007949295",
            "telephone_number": "787-242-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53-1 CALLE 60A",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009573871",
            "telephone_number": "787-242-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENTE",
        "first_name": "MARYSOL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.