Individual provider Active NPI

Renan Lorenzo Velazquez

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1548963416
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23913 Issued in PR
Practice address
690 Calle Washington
San Juan, PR 00926-5623
Phone
(787) 930-3085
NPI assigned
Mar 22, 2023
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 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 23913 PR Primary

Addresses

Primary practice location

690 Calle Washington
San Juan, PR 00926-5623

Mailing address

PO Box 4197
Guaynabo, PR 00970
Phone (787) 930-3085

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
I20240730000147 PR Practitioner - General Practice 7618413410 Practice locations: Fajardo, PR

Care Compare profile

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

Practice addresses (Care Compare)

151 Ave Osvaldo Molina
Fajardo, PR 00738-4013
Phone (787) 801-0081

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23913PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Center Hospital San Juan Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1548963416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4197",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00970",
            "telephone_number": "787-930-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 CALLE WASHINGTON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265623",
            "telephone_number": "787-930-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "RENAN",
        "middle_name": "LORENZO",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.