Individual provider Active NPI

Myriam Amaro de Jesus, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1053394734
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
12744 Issued in PR
Practice address
783 Calle Guatemala
Urb Las Americas
San Juan, PR 00921-2308
Phone
(787) 281-6266
Fax
(787) 292-0130
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 12744 PR Primary

Addresses

Primary practice location

783 Calle Guatemala
Urb Las Americas
San Juan, PR 00921-2308

Mailing address

783 Calle Guatemala
San Juan, PR 00921-2360
Phone (787) 317-9770

Other identifiers 1

IdentifierTypeStateIssuer
12744OtherPRLICENCIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Medical Group Ljcpsc Past Accepting new patients

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1053394734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "783 CALLE GUATEMALA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009212360",
            "telephone_number": "787-317-9770",
            "fax_number": "787-292-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "783 CALLE GUATEMALA",
            "address_2": "URB LAS AMERICAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009212308",
            "telephone_number": "787-281-6266",
            "fax_number": "787-292-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMARO DE JESUS",
        "first_name": "MYRIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "12744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA",
            "identifier": "12744",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.