Individual provider Active NPI

Paloma Vazquez-Davila, M.D.

  • General Practice Physician
  • San German, PR
National Provider Identifier
1669602793
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17657 Issued in PR
Practice address
Calle Tetuan # 4
San German, PR 00683
Phone
(787) 892-5730
NPI assigned
Jul 23, 2009
Last updated
Oct 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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 17657 PR Primary

Addresses

Primary practice location

Calle Tetuan # 4
San German, PR 00683

Mailing address

PO Box 3200
Guayama, PR 00785-3200
Phone (787) 597-7662

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
I20181023001335 PR Practitioner - General Practice 9335449016 Reassigns benefits to 2 organizations
Practice locations: Mayaguez, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayaguez Medical Center Dr Ramon Emeterio Betances Inc CurrentSince Jul 21, 2018 Accepting new patients
Bella Vista Hospital Inc CurrentSince Dec 26, 2018 Accepting new patients
Bella Vista Hospital, Inc CurrentSince Dec 26, 2018 Accepting new patients

Organizations & group practices 3

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": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1669602793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3200",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "007853200",
            "telephone_number": "787-597-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE TETUAN # 4",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-892-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ-DAVILA",
        "first_name": "PALOMA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

Verify at the official NPI Registry.