Individual provider Active NPI

Elena Maria Jimenez, MD

  • Ophthalmology Physician
  • San Juan, PR
National Provider Identifier
1003981804
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
13621 Issued in PR
Practice address
735 Ave Ponce de Leon Ste 503
San Juan, PR 00917-5026
Phone
(787) 510-7880
Fax
(787) 925-1200
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 13621 PR Primary

Addresses

Primary practice location

735 Ave Ponce de Leon Ste 503
San Juan, PR 00917-5026

Mailing address

735 Ave Ponce de Leon Ste 503
San Juan, PR 00917-5026
Phone (787) 510-7880

Other identifiers 3

IdentifierTypeStateIssuer
62095OtherBLUE CROSS
9260093OtherHUMANA
23074OtherPREFERRED

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
I20101215000898 PR Practitioner - Ophthalmology 7315090586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Puerto Rico School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

735 Ave Ponce de Leon
San Juan, PR 00917-5022
Phone (787) 510-7880

Merit-based Incentive Payment System (MIPS)

Final score
89.6 of 100Reported as individual
Quality
81.78
Improvement activities
40
Cost
89.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Eye Care, C.S.P. CurrentSince Aug 18, 2014 Accepting new patients

Locations

735 Ave Ponce de Leon
Ste 503
San Juan, PR 00917
Phone (787) 510-7880

Interoperability endpoints

  • Direct secure messaging: draj@specializedeyecare.direct.eyemdemr.com

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1003981804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON STE 503",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175026",
            "telephone_number": "787-510-7880",
            "fax_number": "787-925-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON STE 503",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175026",
            "telephone_number": "787-510-7880",
            "fax_number": "787-925-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ELENA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "13621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "62095",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "9260093",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED",
            "identifier": "23074",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.