Mario Luis Olivencia Malave, M.D

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

20164 Issued in PR

Practice address

55 Calle de Diego E Ste 401
Mayaguez, PR 00680-5081

Phone

(787) 487-7866

NPI assigned

Nov 5, 2012

Last updated

Jul 18, 2017By the provider in NPPES

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

Specialty

General Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bella Vista Hospital IncGroup PAC ID 6507831351, 14 clinicians

Centro de Diagnostico Y Tratamiento de San Sebastian IncGroup PAC ID 7315924933, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bella Vista Hospital Hospital, Mayaguez, PR, CCN 400014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bella Vista Hospital, Inc

  dba Bella Vista Family Medicine

  • Family Medicine Physician
  • Mayaguez, PR
  • NPI 1881998334
  Medicare reassignment Care Compare group NPD
• Centro de Diagnostico Y Tratamiento de San Sebastian Inc

  • Health Service Clinic/Center
  • San Sebastian, PR
  • NPI 1164466363
  Medicare reassignment Care Compare group
• Bella Vista Hospital, Inc

  dba Bella Vista Anesthesiology Group

  • Anesthesiology Physician
  • Mayaguez, PR
  • NPI 1215827134
  NPD
• Bella Vista Hospital Inc

  • General Acute Care Hospital
  • Mayaguez, PR
  • NPI 1083636179
  NPD (past)
• Centro Neumologico del Oeste

  • Pulmonary Disease Physician
  • Mayaguez, PR
  • NPI 1760463970
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bella Vista Hospital Inc

  • General Acute Care Hospital
  • Mayaguez, PR
  • NPI 1083636179
  Care Compare affiliation

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1770837320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CPR PROFESIONAL BUILDING 65 DE DIEGO E.SUITE STE. 401",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006808501",
            "telephone_number": "787-805-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CALLE DE DIEGO E STE 401",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006805081",
            "telephone_number": "787-487-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVENCIA MALAVE",
        "first_name": "MARIO",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-05",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "20164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abiodun Abayomi Odeleye, M.D.
• Oficina Dental Dr. Raul F. Cordero C.S.P.
• Oficina Medica Dr. Luis J. Suau, CSP
• Juan Andres Oharriz Vina
• Winston Ojeda-Laracuente, M.D.
• Antonio R Olivencia-Echeandia, M.D.
• Humberto N Olivencia, M.D.
• Joel Hesed Olivencia, PHARM. D.
• Catherine I. Oliver, MSW
• Zolymar Oliveras Texeira, OPTICIAN

• General Practice Physician in Mayaguez, PR
• Providers in Mayaguez, 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 18, 2017; 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.
• 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.