Organization Active NPI

JB Dermatology LLC

  • Dermatology Physician
  • Caguas, PR
National Provider Identifier
1003486036
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
JB DERMATOLOGY LLC
Practice address
200 Grand Blvd Los Prados # Z-5
Caguas, PR 00727-9507
Phone
(787) 746-3136
NPI assigned
Jun 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Authorized official

Name
Julian O Barrera Llaurador, MDNPI 1922466325
Title
Owner
Phone
(787) 957-5540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

200 Grand Blvd Los Prados # Z-5
Caguas, PR 00727-9507

Mailing address

PO Box 6775
Caguas, PR 00726-6775

Other practice location 1

286 Ave Domenech
San Juan, PR 00918-3506
Phone (787) 314-4443

Other practice location 2

295 Palmas Inn Way # C120
Humacao, PR 00791-6181
Phone (787) 718-7144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210902000840 PR Part B Supplier - Clinic/Group Practice 7012313828 Receives reassigned benefits from 1 practitioner
Practice locations: Bayamon, PR; Caguas, PR; San Juan, PR

National Provider Directory

National Provider Directory

Locations

295 Palmas Inn Way
#C120
Humacao, PR 00791
Phone (787) 718-7144

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1003486036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6775",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007266775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GRAND BLVD LOS PRADOS # Z-5",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007279507",
            "telephone_number": "787-746-3136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "286 Ave Domenech",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009183506",
            "country_code": "US",
            "telephone_number": "787-314-4443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "295 Palmas Inn Way # C120",
            "address_purpose": "LOCATION",
            "city": "Humacao",
            "state": "PR",
            "postal_code": "007916181",
            "country_code": "US",
            "telephone_number": "787-718-7144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JB DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-30",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "BARRERA LLAURADOR",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-957-5540",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.