Individual provider Active NPI

Edwin Javier Velez, DC

  • Chiropractor
  • San Juan, PR
National Provider Identifier
1700136306
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
507 Issued in PR
Practice address
1751 Ave Paz Granela
Urb Santiago Iglesias
San Juan, PR 00921-3630
Phone
(787) 200-9144
Fax
(787) 200-9108
NPI assigned
Sep 12, 2012
Sex
Male
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Life Chiropractic College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1751 Ave Francisco Paz Granela
Urb. Santiago Iglesias
San Juan, PR 00921-3630

1751 Ave Paz Granela
San Juan, PR 00921-3630
Phone (787) 200-9144

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20130211000271 PR Practitioner - Chiropractic 9931353448 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
507PRMDPhysical Therapist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 507 PR Primary

Addresses

NPPES NPI Registry

Primary practice location

1751 Ave Paz Granela
Urb Santiago Iglesias
San Juan, PR 00921-3630

Mailing address

1751 Ave Paz Granela
Urb Santiago Iglesias
San Juan, PR 00921-3630
Phone (787) 200-9144

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
038455200MedicaidPR

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 17, 2022.

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1700136306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 AVE PAZ GRANELA",
            "address_2": "URB SANTIAGO IGLESIAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213630",
            "telephone_number": "787-200-9144",
            "fax_number": "787-200-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 AVE PAZ GRANELA",
            "address_2": "URB SANTIAGO IGLESIAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213630",
            "telephone_number": "787-200-9144",
            "fax_number": "787-200-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELEZ",
        "first_name": "EDWIN",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-12",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038455200",
            "state": "PR"
        }
    ],
    "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 Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.