MSV Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MSV DERMATOLOGY

Practice address

Dermagallery
Cond Palmanova Plaza Apt C 120
Palmas del Mar, Humacao, PR 00791

Phone

(787) 718-7144

NPI assigned

Jun 2, 2022

Organization subpart

No

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

Authorized official

Name

Marely Santiago Vazquez, MDNPI 1144776865

Title

Owner

Phone

(787) 237-5414

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Marely Santiago Vazquez, MD Doing business as

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: msvdermatology22@direct.practicefusion.com
• Direct secure messaging: msvdermatology@direct.practicefusion.com

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marely Santiago Vazquez, MD

  • Dermatology Physician
  • Palmas del Mar, Humacao, PR
  • NPI 1144776865
  Medicare reassignment NPD Authorized official
• Jorge Ernesto Berrios, PSYD

  • Clinical Neuropsychologist
  • San Juan, PR
  • NPI 1902969611
  NPD (past)
• Estefania Cruzval O'Reilly, MD

  • Dermatology Physician
  • Bayamon, PR
  • NPI 1083239214
  NPD (past)
• Eneida Maria De la Torre - Lugo, M.D.

  • Dermatology Physician
  • Bayamon, PR
  • NPI 1467603027
  NPD (past)
• Alexandra M Montalvo Acevedo, MD

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • San Juan, PR
  • NPI 1174938195

  Single Specialty

  NPD (past)
• Luis J Ortiz-Espinosa, M.D., FAAD

  • Dermatology Physician
  • Carolina, PR
  • NPI 1053390732
  NPD (past)
• Christian E. Schenk, M.D.

  • Neurology Physician
  • Carolina, PR
  • NPI 1316184674
  NPD (past)
• Marisel Vazquez-Correa, M.D.

  • Pediatric Neurodevelopmental Disabilities Physician
  • San Juan, PR
  • NPI 1164482865
  NPD (past)

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1609515147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "H20 PLAZA ONCE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009261452",
            "telephone_number": "787-237-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DERMAGALLERY",
            "address_2": "COND PALMANOVA PLAZA APT C 120",
            "city": "PALMAS DEL MAR, HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-718-7144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Carretera 185 Plaza Rial Mall 5-A",
            "address_purpose": "LOCATION",
            "city": "Canovanas",
            "state": "PR",
            "postal_code": "00729",
            "country_code": "US",
            "telephone_number": "787-998-9725",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Nova Derm",
            "address_2": "venida Comandante Esq. Campo Rico PQ #26",
            "address_purpose": "LOCATION",
            "city": "Carolina",
            "state": "PR",
            "postal_code": "00987",
            "country_code": "US",
            "telephone_number": "787-752-3280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MSV DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-02",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO VAZQUEZ",
        "authorized_official_first_name": "MARELY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-237-5414",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PP539",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "21880",
            "state": "PR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144776865",
            "state": "PR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PP540",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msvdermatology22@direct.practicefusion.com",
            "affiliation": "Y",
            "endpointDescription": "MSV Dermatology",
            "affiliationName": "MSV Dermatology",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "Nova Derm",
            "address_2": "Avenida Comandante Esq. Campo Rico PQ #26",
            "city": "Carolina",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msvdermatology22@direct.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "MSV Dermatology",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "Nova Derm",
            "address_2": "Avenida Comandante Esq. Campo Rico PQ #26",
            "city": "Carolina",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msvdermatology@direct.practicefusion.com",
            "affiliation": "Y",
            "endpointDescription": "MSV Dermatology",
            "affiliationName": "MSV Dermatology",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "Dermagallery",
            "address_2": "Cond Palmanova Plaza Apt C 120",
            "city": "Palmas Del Mar, Humacao",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msvdermatology22@direct.practicefusion.com",
            "affiliation": "Y",
            "endpointDescription": "MSV Dermatology",
            "affiliationName": "MSV Dermatology",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "Carretera 185 Plaza Rial Mall 5-A",
            "city": "Canovanas",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Marely Santiago Vazquez, MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marely Santiago Vazquez, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marely Santiago Vazquez, MD

• Dermatology Physician in Palmas del Mar, Humacao, PR
• Providers in Palmas del Mar, Humacao, PR by specialty
• Dermatology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.