Individual provider Active NPI

Mariela Alejandra Reyes Vazquez, MD

  • General Practice Physician
  • Toa Baja, PR
National Provider Identifier
1730871989
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23979 Issued in PR
Practice address
Urb Valparaiso Calle 3 A20
Toa Baja, PR 00949-4014
Phone
(787) 462-1418
NPI assigned
May 25, 2023
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PR
General Practice Physician 208D00000X 23979 PR Primary

Addresses

Primary practice location

Urb Valparaiso Calle 3 A20
Toa Baja, PR 00949-4014

Mailing address

PO Box 2087
Bayamon, PR 00960-2087
Phone (787) 462-1418

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
I20250328002640 PR Practitioner - General Practice 4284157330 Reassigns benefits to 1 organization
Practice locations: Manati, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atenas Community Health Center Achc Inc CurrentSince Apr 21, 2025 Accepting new patients
Atenas Community Health Center Achc Inc CurrentSince Apr 21, 2025 Accepting new patients

Organizations & group practices 2

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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1730871989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2087",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009602087",
            "telephone_number": "787-462-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB VALPARAISO CALLE 3 A20",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009494014",
            "telephone_number": "787-462-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES VAZQUEZ",
        "first_name": "MARIELA",
        "middle_name": "ALEJANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Baja, PR

Sources for this page

Verify at the official NPI Registry.