Individual provider Active NPI

Julio Vazquez Galliano, M.D.

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Caguas, PR
National Provider Identifier
1972899458
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
022552 Issued in PR
Practice address
2F6 Ave. Luis Munoz Marin
Caguas, PR 00969
Phone
(787) 704-0075
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 279736 NY
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 022552 PR Primary

Addresses

Primary practice location

2F6 Ave. Luis Munoz Marin
Caguas, PR 00969

Mailing address

45 Calle Venus
Caguas, PR 00725-6339
Phone (787) 704-0075

Other practice location 1

344 E 85th St Apt 6J
New York, NY 10028-4575
Phone (212) 684-4325

Other practice location 2

600 E 233rd St
Bronx, NY 10466-2604
Phone (212) 684-4325

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
I20211019000308 PR Practitioner - Sports MedicinePractitioner - Physical Medicine and Rehabilitation 2860701836 Reassigns benefits to 1 organization
Practice locations: Caguas, PR

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Physical Medicine and Rehabilitation
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Advantage Health Center LLCGroup PAC ID 7012301013, 6 clinicians

Practice addresses (Care Compare)

15 Ave Munoz Rivera
San Juan, PR 00901-2480
Phone (888) 900-0073

Hospital & facility affiliations

  • Hospital Pavia Caguas Hospital, Caguas, PR, CCN 400120
  • Metropolitan Hospital Hospital, San Juan, PR, CCN 400106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022552PRMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Center LLC Physical Medicine & Rehabilitation CurrentSince Oct 28, 2022 Accepting new patients
Advantage Rehab and Wellness Center LLC Physical Medicine & Rehabilitation CurrentSince Nov 5, 2023 Accepting new patients
Maxwell Medical PC Physical Medicine & Rehabilitation Past Accepting new patients
Sports and Pain Interventions PSC PastSince Nov 9, 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.

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1972899458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CALLE VENUS",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007256339",
            "telephone_number": "787-704-0075",
            "fax_number": "787-900-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2F6 AVE. LUIS MUNOZ MARIN",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-704-0075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "344 E 85th St Apt 6J",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100284575",
            "country_code": "US",
            "telephone_number": "212-684-4325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 E 233rd St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104662604",
            "country_code": "US",
            "telephone_number": "212-684-4325",
            "fax_number": "718-920-9212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ GALLIANO",
        "first_name": "JULIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "279736",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PR",
            "license": "022552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.