Individual provider Active NPI

Caroline E Vazquez Melendez, LCDA

  • Nutritionist
  • San Juan, PR
National Provider Identifier
1548701691
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
2004 Issued in PR
Practice address
1 Calle Bucare
Condominio Piazeta Aprt #5 Punta Las Marias
San Juan, PR 00913-4638
Phone
(787) 920-4254
NPI assigned
Mar 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 2004 PR Primary

Addresses

Primary practice location

1 Calle Bucare
Condominio Piazeta Aprt #5 Punta Las Marias
San Juan, PR 00913-4638

Mailing address

PO Box 191670
San Juan, PR 00919-1670
Phone (787) 920-4254

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210414001047 PR Practitioner - Registered Dietitian Or Nutrition Professional 2466860382 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

29 Calle Washington
Suite 403
San Juan, PR 00907-1521
Phone (787) 920-4254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2004PRMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vita Care,LLC CurrentSince Jan 6, 2021 Accepting new patients

Locations

10000 Ave 65 Infanteria
Ste 204
Carolina, PR 00985
Phone (787) 523-2458

Interoperability endpoints

  • Direct secure messaging: caroline.vazquezmelendez.p1@direct.vitacare.nextgenshare.com

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": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1548701691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191670",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009191670",
            "telephone_number": "787-920-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CALLE BUCARE",
            "address_2": "CONDOMINIO PIAZETA APRT #5 PUNTA LAS MARIAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009134638",
            "telephone_number": "787-920-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ MELENDEZ",
        "first_name": "CAROLINE",
        "middle_name": "E",
        "credential": "LCDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2023-06-14",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PR",
            "license": "2004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.