Individual provider Active NPI

William Gibran Vega Corsino, M.D.

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1760733927
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19780 Issued in PR
Practice address
Hospital Episcopal San Lucas Metro
Carr 844 KM 0.5
San Juan, PR 00926-4146
Phone
(787) 761-8383
NPI assigned
Sep 27, 2012
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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 19780 PR Primary

Addresses

Primary practice location

Hospital Episcopal San Lucas Metro
Carr 844 KM 0.5
San Juan, PR 00926-4146

Mailing address

Estancias de San Fernando Calle 6 E-6
Carolina, PR 00985

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
I20200921000980 PR Practitioner - General Practice 5193143352 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19780PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Lucas Metro, Inc. 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, 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": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1760733927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ESTANCIAS DE SAN FERNANDO CALLE 6 E-6",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL EPISCOPAL SAN LUCAS METRO",
            "address_2": "CARR 844 KM 0.5",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264146",
            "telephone_number": "787-761-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA CORSINO",
        "first_name": "WILLIAM",
        "middle_name": "GIBRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-27",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.