Individual provider Active NPI

Jose A Perez Hernandez Sr., MD

  • Cardiovascular Disease Physician
  • Mayaguez, PR
National Provider Identifier
1003882143
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4828 Issued in PR
Practice address
De Diego #59 Este
Mayaguez, PR 00680
Phone
(787) 833-6940
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4828 PR Primary

Addresses

Primary practice location

De Diego #59 Este
Mayaguez, PR 00680

Mailing address

PO Box 1841
Mayaguez, PR 00681
Phone (787) 833-6940

Other identifiers 3

IdentifierTypeStateIssuer
065312OtherCA
0391OtherIMC
97123PEOtherSSS

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
I20121009000135 PR Practitioner - Cardiovascular Disease (Cardiology) 6709035629 Reassigns benefits to 1 organization
Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Puerto Rico School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Servicios Cardiovasculares del Oeste IncGroup PAC ID 1759410061, 2 clinicians

Practice addresses (Care Compare)

125 Este Calle de Diego
Mayaguez, PR 00680-5084
Phone (787) 832-0995

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4828PRMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Servicios Cardiovasculares del Oeste, Inc. Cardiovascular Disease CurrentSince Aug 27, 2012 Accepting new patients

Locations

125 Calle de Diego E
Mayaguez, PR 00680
Phone (787) 832-0995

Organizations & group practices 1

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1003882143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1841",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00681",
            "telephone_number": "787-833-6940",
            "fax_number": "787-833-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DE DIEGO #59 ESTE",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-833-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ HERNANDEZ",
        "first_name": "JOSE",
        "middle_name": "A",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PR",
            "license": "4828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA",
            "identifier": "065312",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMC",
            "identifier": "0391",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "97123PE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.