Individual provider Active NPI

Keysha Marie Lopez Vega, MD

  • Nephrology Physician
  • San Juan, PR
National Provider Identifier
1487041596
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
21131 Issued in PR
Practice address
155 Ave Arterial Hostos Apt 222
San Juan, PR 00918-2938
Phone
(787) 316-3753
NPI assigned
Apr 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21131 PR
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X TL.0008177 CO
Nephrology Physician 207RN0300X 21131 PR Primary

Addresses

Primary practice location

155 Ave Arterial Hostos Apt 222
San Juan, PR 00918-2938

Mailing address

1033 Calle Cerro Saliente
Urb. Quintas de Altamira
Juana Diaz, PR 00795-9107
Phone (787) 316-3753

Other practice location 1

1033 Calle Cerro Saliente
Urb. Quintas de Altamira
Juana Diaz, PR 00795-9107
Phone (787) 316-3753

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
I20210525001426 PR Practitioner - NephrologyPractitioner - Internal Medicine 6507296001 Reassigns benefits to 2 organizations
Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Recinto de Ciencias MedicasGroup PAC ID 3678469962, 246 clinicians

Practice addresses (Care Compare)

Bo Monacillos Centro Medico de PR
Administracion de Servicios Medicos (Asem)
Rio Piedras, PR 00935
Phone (787) 777-3535

Ponce de Leon Ave
715 Stop 37.5
San Juan, PR 00918-1000
Phone (787) 771-7934

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
66.19
Improvement activities
40
Cost
73.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL.0008177COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas Single Specialty CurrentSince Jun 3, 2022 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Recinto de Ciencias Medicas Single Specialty CurrentSince Jun 3, 2022 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. Single Specialty CurrentSince Jul 1, 2021 Accepting new patients

Locations

715 Ave Ponce de Leon
#375
San Juan, PR 00917
Phone (787) 717-6763

BO Monacillos Centro Medico De
San Juan, PR 00935
Phone 78775825252379

715 Ave Ponce de Leon
San Juan, PR 00917
Phone 7877582000 ext. 3216

715 Ave Ponce de Leon
Stop 375
San Juan, PR 00917
Phone 7877582000 ext. 3216

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1487041596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 CALLE CERRO SALIENTE",
            "address_2": "URB. QUINTAS DE ALTAMIRA",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007959107",
            "telephone_number": "787-316-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 AVE ARTERIAL HOSTOS APT 222",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009182938",
            "telephone_number": "787-316-3753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1033 Calle Cerro Saliente",
            "address_2": "Urb. Quintas de Altamira",
            "address_purpose": "LOCATION",
            "city": "Juana Diaz",
            "state": "PR",
            "postal_code": "007959107",
            "country_code": "US",
            "telephone_number": "787-316-3753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ VEGA",
        "first_name": "KEYSHA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-16",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "21131",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL.0008177",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PR",
            "license": "21131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.