Individual provider Active NPI

Victor Adolfo Marcial-Vega, M.D.

  • Independent Medical Examiner Physician
  • San Juan, PR
National Provider Identifier
1699977579
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Medical Examiner PhysicianTaxonomy code 202C00000X
License
9746 Issued in PR
Practice address
374 Calle Eddie Gracia
Urb Ext Roosevelt
San Juan, PR 00918-2107
Phone
(787) 767-2587
NPI assigned
Jun 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner Physician 202C00000X 9746 PR Primary

Addresses

Primary practice location

374 Calle Eddie Gracia
Urb Ext Roosevelt
San Juan, PR 00918-2107

Mailing address

374 Calle Eddie Gracia
Urb Ext Roosevelt
San Juan, PR 00918-2107
Phone (787) 767-2587

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
I20150727000903 PR Order and Referring Only - Radiation OncologyPractitioner - Radiation Oncology 1759340698

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1699977579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 CALLE EDDIE GRACIA",
            "address_2": "URB EXT ROOSEVELT",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009182107",
            "telephone_number": "787-767-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 CALLE EDDIE GRACIA",
            "address_2": "URB EXT ROOSEVELT",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009182107",
            "telephone_number": "787-767-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCIAL-VEGA",
        "first_name": "VICTOR",
        "middle_name": "ADOLFO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "PR",
            "license": "9746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.