Individual provider Active NPI

Juan Carlos Velasco-Cervilla, MD

  • Internal Medicine Physician
  • Yauco, PR
National Provider Identifier
1659305225
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10541 Issued in PR
Practice address
40 Calle 25 de Julio
Yauco, PR 00698-3601
Phone
(787) 267-2811
Fax
(787) 267-1964
NPI assigned
Jul 10, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10541 PR Primary

Addresses

Primary practice location

40 Calle 25 de Julio
Yauco, PR 00698-3601

Mailing address

40 - 25 De Julio
Yauco, PR 00698-0000
Phone (787) 267-2811

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
I20071219000101 PR Practitioner - Internal Medicine 3375633076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Juan C. Velasco Cervilla MD CSPGroup PAC ID 7911097621, 2 clinicians

Practice addresses (Care Compare)

40 Calle 25 de Julio
Yauco, PR 00698-3601
Phone (787) 267-2811

PO Box
Suite 3004
Yauco, PR 00698

PO Box
Suite 3004
Yauco, PR 00698-3004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10541PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Medical Alliance, Inc. Current Accepting new patients
Southern Medical Alliance, Inc. Internal Medicine Current Accepting new patients
Juan C. Velasco Cervilla MD CSP Internal Medicine CurrentSince Oct 23, 2007 Accepting new patients

Locations

40 Calle 25 de Julio
Yauco, PR 00698
Phone (787) 267-2811

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1659305225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 - 25 DE JULIO",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006980000",
            "telephone_number": "787-267-2811",
            "fax_number": "787-267-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CALLE 25 DE JULIO",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006983601",
            "telephone_number": "787-267-2811",
            "fax_number": "787-267-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO-CERVILLA",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "10541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yauco, PR

Sources for this page

Verify at the official NPI Registry.