Individual provider Active NPI

Christian Velazquez Tirado, MD

  • General Practice Physician
  • San German, PR
National Provider Identifier
1962279406
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23659 Issued in PR
Practice address
Hospital de la Concepcion
PR-2 KM 173,
San German, PR 00683
Phone
(787) 892-1860
NPI assigned
Dec 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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 23659 PR Primary

Addresses

Primary practice location

Hospital de la Concepcion
PR-2 KM 173,
San German, PR 00683

Mailing address

Hospital de la Concepcion
PR-2 KM 173,
San German, PR 00683
Phone (787) 533-7634

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
I20251112003312 PR Practitioner - General Practice 7517458011 Practice locations: San German, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16 Calle 65 Infntria S
Lajas, PR 00667-2001

PR 2 KM
Suite 173
San German, PR 00683-4266
Phone (787) 533-7634

Hospital & facility affiliations

  • Hospital de la Concepcion Hospital, San German, PR, CCN 400021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23659PRMDGeneral Practice Physician

Hospital & facility affiliations 1

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": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1962279406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HOSPITAL DE LA CONCEPCION",
            "address_2": "PR-2 KM 173,",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-533-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL DE LA CONCEPCION",
            "address_2": "PR-2 KM 173,",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-892-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ TIRADO",
        "first_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-05",
        "last_updated": "2024-03-12",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

Verify at the official NPI Registry.