Individual provider Active NPI

Elena M De Jesus Pagan, MD

  • Obstetrics & Gynecology Physician
  • Toa Baja, PR
National Provider Identifier
1003873969
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
11043 Issued in PR
Practice address
2823 Ave Dos Palmas
Urb. Levittown
Toa Baja, PR 00949-4106
Phone
(787) 795-3260
Fax
(787) 795-1225
NPI assigned
Apr 26, 2006
Last updated
Oct 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 11043 PR Primary

Addresses

Primary practice location

2823 Ave Dos Palmas
Urb. Levittown
Toa Baja, PR 00949-4106

Mailing address

8058 Plaza Gaviotas
Urb Camino del Mar
Toa Baja, PR 00949-4379
Phone (787) 795-3260

Other identifiers 3

IdentifierTypeStateIssuer
5710OtherPRIMC
83411OtherPRSSS
9490009OtherPRHUMANAPR

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
I20120514000175 PR Practitioner - Obstetrics/Gynecology 0446413397 Practice locations: Toa Baja, PR

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Puerto Rico School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8058 Plaza Gaviotas
Toa Baja, PR 00949-4379
Phone (787) 795-3260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11043PRMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1003873969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8058 PLAZA GAVIOTAS",
            "address_2": "URB CAMINO DEL MAR",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009494379",
            "telephone_number": "787-795-3260",
            "fax_number": "787-795-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 AVE DOS PALMAS",
            "address_2": "URB. LEVITTOWN",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009494106",
            "telephone_number": "787-795-3260",
            "fax_number": "787-795-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS PAGAN",
        "first_name": "ELENA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PR",
            "license": "11043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMC",
            "identifier": "5710",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "83411",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANAPR",
            "identifier": "9490009",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Baja, PR

Sources for this page

Verify at the official NPI Registry.