Individual provider Active NPI

Vicente V Nazario Laracuente

  • General Practice Physician
  • Mayaguez, PR
National Provider Identifier
1942715107
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19819 Issued in PR
Practice address
Paseo Los Robles Calle Ramon Quiles 1307
Mayaguez, PR 00680
Phone
(787) 361-7101
NPI assigned
Dec 11, 2017
Last updated
May 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 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 19819 PR Primary

Addresses

Primary practice location

Paseo Los Robles Calle Ramon Quiles 1307
Mayaguez, PR 00680

Mailing address

PO Box 2412
Mayaguez, PR 00681-2412

Other practice location 1

Urb Paseo los robles solar 1307
Mayaguez, PR 00680
Phone (787) 361-7101

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
I20200611001166 PR Practitioner - General Practice 0345661724 Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Mayaguez, PR 00680
Phone (787) 361-7101

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19819PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vicente Nazario Laracuente LLC CurrentSince Feb 19, 2023 Accepting new patients
Ryder Memorial Hospital Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1942715107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2412",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006812412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PASEO LOS ROBLES CALLE RAMON QUILES 1307",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-361-7101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Urb Paseo los robles solar 1307",
            "address_purpose": "LOCATION",
            "city": "Mayaguez",
            "state": "PR",
            "postal_code": "00680",
            "country_code": "US",
            "telephone_number": "787-361-7101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZARIO LARACUENTE",
        "first_name": "VICENTE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-11",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.