Active NPI
Ian Javier Vazquez, LND, RD
- Registered Dietitian
- San Juan, PR
National Provider Identifier
1629625850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2104
- Practice address
- 1456 Calle Prof. Augusto Rodriguez
San Juan, PR 00909 - Phone
- (787) 230-7530
- NPI assigned
- Aug 22, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2104 | PR | Primary |
Addresses
Primary practice location
1456 Calle Prof. Augusto Rodriguez
San Juan, PR 00909
Mailing address
Urb. Lomas Verdes
2 J 10 Calle Flamboyan
Bayamon, PR 00956-3429
Phone (787) 662-6348
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230509002740 | PR | Practitioner - Registered Dietitian Or Nutrition Professional | 5294191615 | Practice locations: Bayamon, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Heroes Incorporated | Dietitian, Registered | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735776000000",
"number": "1629625850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB. LOMAS VERDES",
"address_2": "2 J 10 CALLE FLAMBOYAN",
"city": "BAYAMON",
"state": "PR",
"postal_code": "009563429",
"telephone_number": "787-662-6348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1456 CALLE PROF. AUGUSTO RODRIGUEZ",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00909",
"telephone_number": "787-230-7530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAZQUEZ",
"first_name": "IAN",
"middle_name": "JAVIER",
"credential": "LND, RD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-22",
"last_updated": "2025-01-02",
"certification_date": "2025-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "2104",
"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 Jan 2, 2025; 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.