Individual provider Active NPI

Myrta Lopez Vazquez, MD GEN

  • General Practice Physician
  • Arecibo, PR
National Provider Identifier
1861542508
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9531 Issued in PR
Practice address
Urb Villa Los Santos
Calle 16 V1
Arecibo, PR 00612
Phone
(787) 879-1585
Fax
(787) 879-4315
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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 9531 PR Primary

Addresses

Primary practice location

Urb Villa Los Santos
Calle 16 V1
Arecibo, PR 00612

Mailing address

PO Box 9091
Cotto Station
Arecibo, PR 00613
Phone (787) 879-1585

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
I20121025000135 PR Practitioner - General SurgeryPractitioner - General Practice 2668622895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Puerto Rico School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villa Los Santos Clinic LLCGroup PAC ID 9032652037, 3 clinicians

Practice addresses (Care Compare)

V1 Calle
Suite 16
Arecibo, PR 00612-3112
Phone (787) 879-1585

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Villa Los Santos Clinic, LLC General Practice Current Accepting new patients
Villa Los Santos Clinic, LLC General Practice CurrentSince May 1, 2024 Accepting new patients
Villa Los Santos Clinic, LLC CurrentSince May 1, 2024 Accepting new patients
Laboratorio Clinico Villa Los Santos Current Accepting new patients
Servicios de Salud del Norte General Practice CurrentSince Oct 16, 2012 Accepting new patients

Locations

V1 Calle 16
Arecibo, PR 00612
Phone (787) 817-3144

Organizations & group practices 5

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1861542508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9091",
            "address_2": "COTTO STATION",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00613",
            "telephone_number": "787-879-1585",
            "fax_number": "787-879-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB VILLA LOS SANTOS",
            "address_2": "CALLE 16 V1",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-879-1585",
            "fax_number": "787-879-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ VAZQUEZ",
        "first_name": "MYRTA",
        "name_prefix": "Mrs.",
        "credential": "MD GEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.