Organization Active NPI

Northern Integrated Medical

  • General Practice Physician
  • Morovis, PR
National Provider Identifier
1528670973
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
NORTHERN INTEGRATED MEDICAL
Practice address
Carr 6622 KM 2.2
Bo Morovis Sur Sector la Linea
Morovis, PR 00687
Phone
(787) 617-4636
NPI assigned
Aug 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Authorized official

Name
Dr. Juan Carlos Torres Velazquez, MDNPI 1366482036
Title
Presidente
Phone
(787) 617-4636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

Carr 6622 KM 2.2
Bo Morovis Sur Sector la Linea
Morovis, PR 00687

Mailing address

Estancias de Tortuguero
438 Calle Tulane
Vega Baja, PR 00693-3642
Phone (787) 617-4636

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201026000329 PR Part B Supplier - Clinic/Group Practice 6305266602 Receives reassigned benefits from 1 practitioner
Practice locations: Morovis, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1597708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1528670973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ESTANCIAS DE TORTUGUERO",
            "address_2": "438 CALLE TULANE",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006933642",
            "telephone_number": "787-617-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 6622 KM 2.2",
            "address_2": "BO MOROVIS SUR SECTOR LA LINEA",
            "city": "MOROVIS",
            "state": "PR",
            "postal_code": "00687",
            "telephone_number": "787-617-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN INTEGRATED MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "TORRES VELAZQUEZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-617-4636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morovis, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.