Wilfredo Jose Vicente, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

22411 Issued in PR

Practice address

Urb. River Plantation
Hoconuco 062, #JJ4
Canovanas, PR 00729

Phone

(787) 372-3937

NPI assigned

Jul 21, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Salud Integral En la Montana, Inc

  • Federally Qualified Health Center (FQHC)
  • Orocovis, PR
  • NPI 1487677159

  General Practice

  Medicare reassignment NPD
• Salud Integral En la Montana, Inc.

  dba Centro Salud Integral en Dorado

  • Clinic/Center
  • Dorado, PR
  • NPI 1760371868
  NPD
• Salud Integral En la Montana, Inc

  • Radiology Clinic/Center
  • Orocovis, PR
  • NPI 1740732890
  NPD (past)

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1740853399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 768",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "007050768",
            "telephone_number": "787-372-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. RIVER PLANTATION",
            "address_2": "HOCONUCO 062, #JJ4",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-372-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENTE",
        "first_name": "WILFREDO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manuel Enrique Vazquez, MD
• Mariana Gabriela Vazquez
• Geraline N Vega, RN, MSN, EDD
• Ana C Velazquez, CPL 1235
• Veoveo Optika, LLC
• Nicole Viera Jimenez
• Alejandra Andresa Villagrasa Flores, M.D.
• Angelica Cristina Villalobos, PA
• Wal-Mart Puerto Rico Inc (Walmart Pharmacy 10-5802)
• Wal-Mart Puerto Rico Inc (Walmart Vision Center 30-5802)

• General Practice Physician in Canovanas, PR
• Providers in Canovanas, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.