Individual provider Active NPI

Wilkins Feliciano Acevedo

  • Physical Therapist
  • Sabana Grande, PR
National Provider Identifier
1619958857
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1189 Issued in PR
Practice address
100 Ave 5 de Diciembre
Sabana Grande, PR 00637-1961
Phone
(787) 873-5999
Fax
(787) 873-5999
NPI assigned
Nov 7, 2005
Last updated
Apr 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1189 PR Primary

Addresses

Primary practice location

100 Ave 5 de Diciembre
Sabana Grande, PR 00637-1961

Mailing address

PO Box 1381
Aguada, PR 00602-1381
Phone (787) 873-5999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050621000057 PR Practitioner - Physical Therapist in Private Practice 5890607154 Practice locations: Rincon, PR; Sabana Grande, PR

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Ave 5 de Diciembre
Sabana Grande, PR 00637-1961
Phone (787) 873-5999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1189PRMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Equipos Medicos by la Monserrate LLC CurrentSince Apr 24, 2022 Accepting new patients
Terapias la Monserrate,Inc Current Accepting new patients
Home Health la Monserrate, Inc Current Accepting new patients
Terapia Fisica la Monserrate Physical Therapist PastSince Jan 15, 2023 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Home Health la Monserrate, IncSabana Grande, PR, CCN 407050 Home health agency 5% Or Greater Direct Ownership Interest (50%)
Corporate Director
W-2 Managing Employee
Sep 1, 2012
Nov 16, 2012
Nov 16, 2012
Hospicio la MonserrateSabana Grande, PR, CCN 401573 Hospice 5% Or Greater Direct Ownership Interest (50%)
Corporate Director (50%)
W-2 Managing Employee (50%)
Oct 30, 2013
Oct 30, 2013
Oct 30, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1619958857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1381",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006021381",
            "telephone_number": "787-873-5999",
            "fax_number": "787-873-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 AVE 5 DE DICIEMBRE",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "006371961",
            "telephone_number": "787-873-5999",
            "fax_number": "787-873-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICIANO ACEVEDO",
        "first_name": "WILKINS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "1189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sabana Grande, PR

Sources for this page

Verify at the official NPI Registry.