Individual provider Active NPI

Ricardo J Blondet Vissepo, M.D.

  • Internal Medicine Physician
  • Ponce, PR
National Provider Identifier
1679594337
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14575 Issued in PR
Practice address
8133 Calle Concordia Ste 104
Edificio Concordia
Ponce, PR 00717-1543
Phone
(787) 842-5315
NPI assigned
Jul 21, 2006
Last updated
Jan 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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 14575 PR Primary

Addresses

Primary practice location

8133 Calle Concordia Ste 104
Edificio Concordia
Ponce, PR 00717-1543

Mailing address

8133 Calle Concordia Ste 104
Edificio Concordia
Ponce, PR 00717-1543
Phone (787) 842-5315

Other identifiers 1

IdentifierTypeStateIssuer
14575OtherPRMEDICAL LICENSE

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
I20051130000621 PR Practitioner - Internal Medicine 0042230443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RJBV Internal Medicine PSCGroup PAC ID 9032245295, 4 clinicians

Practice addresses (Care Compare)

8131 Calle Concordia
Suite 101
Ponce, PR 00717-1543
Phone (787) 842-5315

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
RJBV Internal Medicine, PSC CurrentSince Jan 11, 2010 Accepting new patients

Locations

8131 Calle Concordia
Ste 101
Ponce, PR 00717
Phone (787) 842-5315

8133 Calle Concordia
Ste 104
Ponce, PR 00717
Phone (787) 842-5315

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1679594337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8133 CALLE CONCORDIA STE 104",
            "address_2": "EDIFICIO CONCORDIA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171543",
            "telephone_number": "787-842-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8133 CALLE CONCORDIA STE 104",
            "address_2": "EDIFICIO CONCORDIA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171543",
            "telephone_number": "787-842-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLONDET VISSEPO",
        "first_name": "RICARDO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "14575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "14575",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.