Individual provider Active NPI

Kid Khayam Velez Melendez Sr., MD

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1700477874
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22155 Issued in PR
Practice address
Chalets de la Fuente
8 Calle Floridiano Apt 802
Carolina, PR 00987
Phone
(787) 506-1276
NPI assigned
Feb 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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 22155 PR Primary

Addresses

Primary practice location

Chalets de la Fuente
8 Calle Floridiano Apt 802
Carolina, PR 00987

Mailing address

HC 3 Box 12745
Carolina, PR 00987-9637
Phone (787) 506-1276

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
I20221125000509 PR Practitioner - General Practice 5890163752 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

371 Ave de Diego
San Juan, PR 00909

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grupo Gastroenterologico del Caribe, CSP Past Accepting new patients

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.

Hospital & facility affiliations 4

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": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1700477874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 3 BOX 12745",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009879637",
            "telephone_number": "787-506-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHALETS DE LA FUENTE",
            "address_2": "8 CALLE FLORIDIANO APT 802",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "787-506-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELEZ MELENDEZ",
        "first_name": "KID",
        "middle_name": "KHAYAM",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-01",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.