Individual provider Active NPI

Miguel Ali Velazquez Valle, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Gurabo, PR
National Provider Identifier
1962567248
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
14177 Issued in PR
Practice address
Calle San Antonio Final #941 Salida Barrio Jaguas
Gurabo Community Health Center
Gurabo, PR 00778
Phone
(787) 737-2311
Fax
(787) 737-2377
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 14177 PR Primary

Addresses

Primary practice location

Calle San Antonio Final #941 Salida Barrio Jaguas
Gurabo Community Health Center
Gurabo, PR 00778

Mailing address

H7 Calle Caoba
Mansiones Colinas de Cupey
San Juan, PR 00926-7554
Phone (787) 946-0072

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
I20040204000096 PR Practitioner - Family PracticePractitioner - Geriatric Medicine 7719870864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
University of Puerto Rico School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neomed Center, IncGroup PAC ID 1850284100, 66 clinicians

Practice addresses (Care Compare)

PO Box
Suite 1277
Gurabo, PR 00778-1277

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neomed Center, Inc Current Accepting new patients
Neomed Center, Inc. CurrentSince Jul 1, 2004 Accepting new patients
Neomed Center, Inc CurrentSince Jul 1, 2004 Accepting new patients
Centro de Medicina Primaria Y Geriatria PSC Family Medicine PastSince Jul 1, 2021 Accepting new patients

Organizations & group practices 4

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1962567248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "H7 CALLE CAOBA",
            "address_2": "MANSIONES COLINAS DE CUPEY",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009267554",
            "telephone_number": "787-946-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SAN ANTONIO FINAL #941 SALIDA BARRIO JAGUAS",
            "address_2": "GURABO COMMUNITY HEALTH CENTER",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-737-2311",
            "fax_number": "787-737-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ VALLE",
        "first_name": "MIGUEL",
        "middle_name": "ALI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PR",
            "license": "14177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurabo, PR

Sources for this page

Verify at the official NPI Registry.