Individual provider Active NPI

Liz I Vergara Cordero, M.D.

  • General Practice Physician
  • Las Piedras, PR
National Provider Identifier
1841508561
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
18025 Issued in PR
Practice address
Bo Montones 1 Carr 183 KM 19.3
Las Piedras, PR 00771-0077
Phone
(787) 733-9922
NPI assigned
Sep 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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 18025 PR Primary

Addresses

Primary practice location

Bo Montones 1 Carr 183 KM 19.3
Las Piedras, PR 00771-0077

Mailing address

PO Box 1475
Las Piedras, PR 00771
Phone (787) 733-9922

Other practice location 1

Corporacion Puertorriquena de Salud
Ave. Luis Munoz Marin
Caguas, PR 00725
Phone (787) 653-5353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120807000265 PR Practitioner - General PracticePractitioner - Emergency Medicine 5799931762 Reassigns benefits to 1 organization
Practice locations: Las Piedras, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Las Piedras, PR 00771

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18025PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc General Practice CurrentSince May 27, 2012 Accepting new patients
Centro Medico del Turabo Inc CurrentSince May 27, 2012 Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1841508561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "00771",
            "telephone_number": "787-733-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO MONTONES 1 CARR 183 KM 19.3",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007710077",
            "telephone_number": "787-733-9922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Corporacion Puertorriquena de Salud",
            "address_2": "Ave. Luis Munoz Marin",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "00725",
            "country_code": "US",
            "telephone_number": "787-653-5353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERGARA CORDERO",
        "first_name": "LIZ",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2020-12-01",
        "certification_date": "2020-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Piedras, PR

Sources for this page

Verify at the official NPI Registry.