Individual provider Active NPI

Raquel Vazquez, NP

  • Primary Care Nurse Practitioner
  • Provo, UT
National Provider Identifier
1518690890
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
10246436-4405 Issued in UT
Practice address
589 S State St
Provo, UT 84606-5056
Phone
(801) 429-2000
Fax
(801) 429-2001
NPI assigned
Jul 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X 10246436-4405 UT Primary

Addresses

Primary practice location

589 S State St
Provo, UT 84606-5056

Mailing address

589 S State St
Provo, UT 84606-5056
Phone (801) 429-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20230629000974 UT Practitioner - General Practice 2062871742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

589 S State St
Provo, UT 84606-5056
Phone (801) 429-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainlands Community Health Center, Inc. CurrentSince Apr 17, 2023 Accepting new patients
Mountainlands Community Health Center, Inc Single Specialty CurrentSince Apr 17, 2023 Accepting new patients

Locations

589 S State St
Provo, UT 84606
Phone (801) 420-2000

Interoperability endpoints

  • Direct secure messaging: raquel.vasquez.1@11721.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1518690890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056",
            "telephone_number": "801-429-2000",
            "fax_number": "801-429-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056",
            "telephone_number": "801-429-2000",
            "fax_number": "801-429-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "RAQUEL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "UT",
            "license": "10246436-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.