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DR. KEIVAN A TAVAKOLI MD
NPI 1386242253
General Practice in San Juan, PR

Active since October 13, 2020PECOS Enrolled
PO BOX 364708, SAN JUAN, PR 00936(787) 758-8383 Get Directions Write a Review

NPPES record last updated: December 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 9, 2024, Nov 23, 2022, Jul 13, 2021 and 4 more (7 updates tracked since 2020).

About Dr. Keivan A Tavakoli Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEIVAN A TAVAKOLI MD (NPI 1386242253) is an individual general practice provider in San Juan, Puerto Rico, licensed in Puerto Rico (22049) and active in the NPI registry since October 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386242253
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. KEIVAN A TAVAKOLICredential: MD
Location AddressPO BOX 364708San Juan, PR 00936-4708
Mailing Address153 Calle EbanoGuaynabo, PR 00968-3423 · (703) 474-0096
Phone(787) 758-8383
Sole ProprietorNo
Enumeration DateOctober 13, 2020
Last NPPES UpdateDecember 9, 20247 updates tracked since enumeration
NPPES CertifiedDecember 9, 2024
✔ NPI 1386242253 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Licenses✔ Licensed in PR · 22049✔ Licensed in FL · ACN1322
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Keivan A Tavakoli Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTOPHER WAGNER MD
Student in an Organized Health Care Education/Training Program
PO BOX 364708
SAN JUAN, PR 00936
San Juan Municipio (787) 758-8383
CARMEN MARIA POVENTUD VAZQUEZ CPHT
Pharmacy Technician
PO BOX 364708
SAN JUAN, PR 00936
San Juan Municipio (787) 758-8383
ELIZABETH BURGOS PAGAN
Pharmacy Technician
PO BOX 364708
SAN JUAN, PR 00936
San Juan Municipio (787) 758-8383
LIZA MINERVA RAMOS QUINTANA MD
Student in an Organized Health Care Education/Training Program
PO BOX 364708
SAN JUAN, PR 00936
San Juan Municipio (787) 758-8383
LUZ DELIA RIVERA RODRIGUEZ CPHT
Pharmacy Technician
PO BOX 364708
SAN JUAN, PR 00936
San Juan Municipio (787) 758-8383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keivan Tavakoli's NPI number?

The NPI number for Keivan Tavakoli is 1386242253. It was assigned to this individual provider in the NPPES registry on October 13, 2020.

Where is Keivan Tavakoli located?

Keivan Tavakoli practices at PO Box 364708, San Juan, PR 00936. The listed phone number is (787) 758-8383.

What is Keivan Tavakoli's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Keivan Tavakoli enrolled in Medicare?

Yes. Keivan Tavakoli is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Keivan Tavakoli was last updated on December 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.