Jerrdam Medical, CSP

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

JERRDAM MEDICAL, CSP

Practice address

Calle 21 U 3#5
Las Lomas
Rio Piedras, PR 00921

Phone

(787) 775-2545

NPI assigned

Nov 13, 2006

Organization subpart

No

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

Authorized official

Name

Jorge A Ruiz Roman

Title

Presidente

Phone

(787) 775-2545

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jorge E Ruiz Roman

  • Infectious Disease Physician
  • Rio Piedras, PR
  • NPI 1033212378
  Medicare reassignment NPD
• Damaris Torres Paoli, M.D.

  • Dermatology Physician
  • Rio Piedras, PR
  • NPI 1922101260
  Medicare reassignment NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043381080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 409 PO BOX 194000",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009194000",
            "telephone_number": "787-775-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 21 U 3#5",
            "address_2": "LAS LOMAS",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "00921",
            "telephone_number": "787-775-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRDAM MEDICAL, CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUIZ ROMAN",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-775-2545"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Rio Piedras, PR
• Providers in Rio Piedras, PR by specialty
• Specialist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.