Individual provider Active NPI

Jorge E Ruiz Roman

  • Infectious Disease Physician
  • Rio Piedras, PR
National Provider Identifier
1033212378
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
10805 Issued in PR
Practice address
U3 #5 Calle 21
Las Lomas
Rio Piedras, PR 00921
Phone
(787) 775-2545
Fax
(787) 793-0835
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 10805 PR Primary

Addresses

Primary practice location

U3 #5 Calle 21
Las Lomas
Rio Piedras, PR 00921

Mailing address

PO Box 194000
PMB 409
San Juan, PR 00919-4000
Phone (787) 775-2545

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
I20120221000262 PR Practitioner - Internal MedicinePractitioner - Infectious Disease 0345408423 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10805PRMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jerrdam Medical, CSP CurrentSince Jul 23, 2017 Accepting new patients

Locations

U3-5 Carr 21
San Juan, PR 00921

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033212378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 194000",
            "address_2": "PMB 409",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009194000",
            "telephone_number": "787-775-2545",
            "fax_number": "787-793-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "U3 #5 CALLE 21",
            "address_2": "LAS LOMAS",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "00921",
            "telephone_number": "787-775-2545",
            "fax_number": "787-793-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ ROMAN",
        "first_name": "JORGE",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PR",
            "license": "10805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Piedras, PR

Sources for this page

Verify at the official NPI Registry.