Individual provider Active NPI

Mabel Quintana-Velazquez, MD

  • General Practice Physician
  • Mayaguez, PR
National Provider Identifier
1497467336
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23609 Issued in PR
Practice address
Plaza Yaguez Calle Candelaria 114
Oficina 206
Mayaguez, PR 00680
Phone
(787) 834-2068
NPI assigned
Dec 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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 23609 PR Primary

Addresses

Primary practice location

Plaza Yaguez Calle Candelaria 114
Oficina 206
Mayaguez, PR 00680

Mailing address

PO Box 2866
Moca, PR 00676-2866

Other practice location 1

Ave. Hostos #410 carr. 2 Bo Sabalos
Mayaguez, PR 00680
Phone (787) 652-9200

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
I20240513002111 PR Practitioner - General Practice 0042651754 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23609PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Xcruz MD PSC CurrentSince Jun 1, 2024 Accepting new patients

Locations

410 Ave Hostos
Ste 2
Mayaguez, PR 00682
Phone (787) 360-3244

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1497467336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2866",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006762866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PLAZA YAGUEZ CALLE CANDELARIA 114",
            "address_2": "OFICINA 206",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-834-2068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Ave. Hostos #410 carr. 2 Bo Sabalos",
            "address_purpose": "LOCATION",
            "city": "Mayaguez",
            "state": "PR",
            "postal_code": "00680",
            "country_code": "US",
            "telephone_number": "787-652-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINTANA-VELAZQUEZ",
        "first_name": "MABEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.