Individual provider Active NPI

Edwin David Vega-Feliciano, MD

  • Obstetrics & Gynecology Physician
  • San Juan, PR
National Provider Identifier
1467441386
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
3831 Issued in PR
Practice address
112 Medina Center
Ste 110
San Juan, PR 00928-0930
Phone
(787) 767-0770
Fax
(787) 767-0770
NPI assigned
Oct 14, 2005
Last updated
Sep 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 3831 PR Primary

Addresses

Primary practice location

112 Medina Center
Ste 110
San Juan, PR 00928-0930

Mailing address

PO Box 20930
San Juan, PR 00928-0930
Phone (787) 767-0770

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
I20120320000207 PR Practitioner - Obstetrics/Gynecology 6406016047 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3831PRMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1467441386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20930",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009280930",
            "telephone_number": "787-767-0770",
            "fax_number": "787-767-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MEDINA CENTER",
            "address_2": "STE 110",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009280930",
            "telephone_number": "787-767-0770",
            "fax_number": "787-767-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA-FELICIANO",
        "first_name": "EDWIN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PR",
            "license": "3831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.