NPIMap

Organization Active NPI

Dajaos Medical Center CSP

  • Clinic/Center
  • Bayamon, PR
National Provider Identifier
1528222676
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
894CP Issued in PR
Legal business name
DAJAOS MEDICAL CENTER CSP
Practice address
167 Road KM 11 0 Bo Dajaos
Bayamon, PR 00956-9711
Phone
(787) 730-3446
NPI assigned
Jul 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Authorized official

Name
Rafael Vazquez Perez, MD
Title
President
Phone
(787) 730-3446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 894CP PR Primary

Addresses

Primary practice location

167 Road KM 11 0 Bo Dajaos
Bayamon, PR 00956-9711

Mailing address

RR 14 Box 5334
Bayamon, PR 00956-9711
Phone (787) 730-3446

Other identifiers 4

IdentifierTypeStateIssuer
6320088OtherPRHUMANA
82154OtherPRSSS
500140OtherPRMMM
06548OOtherPRCRUZ AZUL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100729000121 PR Part B Supplier - Clinic/Group Practice 6204969116 Receives reassigned benefits from 3 practitioners
Practice locations: Bayamon, PR; Toa Alta, PR

National Provider Directory

National Provider Directory
Tax ID family
Dajaos Medical Center CSP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5334 RR 14
Bayamon, PR 00956
Phone (787) 279-3632

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1528222676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 14 BOX 5334",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009569711",
            "telephone_number": "787-730-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 ROAD KM 11 0 BO DAJAOS",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009569711",
            "telephone_number": "787-730-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAJAOS MEDICAL CENTER CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ PEREZ",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-730-3446",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PR",
            "license": "894CP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "6320088",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "82154",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM",
            "identifier": "500140",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "06548O",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.