Individual provider Active NPI

Juan L Rosado de Jesus, 19435

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1053763821
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19435 Issued in PR
Practice address
1135 Plaza Iturregui Ave 65 Infanteria
Suite 200-C
San Juan, PR 00924-3400
Phone
(787) 230-7775
NPI assigned
Jul 5, 2016
Last updated
May 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 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 19435 PR Primary

Addresses

Primary practice location

1135 Plaza Iturregui Ave 65 Infanteria
Suite 200-C
San Juan, PR 00924-3400

Mailing address

1135 Plaza Iturregui Ave 65 Infanteria
Suite 200-C
San Juan, PR 00924-3400
Phone (787) 230-7775

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
I20210311001700 PR Practitioner - General Practice 0143636456 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19435PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vip Medical Group LLC General Practice 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1053763821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 PLAZA ITURREGUI AVE 65 INFANTERIA",
            "address_2": "SUITE 200-C",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009243400",
            "telephone_number": "787-230-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 PLAZA ITURREGUI AVE 65 INFANTERIA",
            "address_2": "SUITE 200-C",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009243400",
            "telephone_number": "787-230-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO DE JESUS",
        "first_name": "JUAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "19435",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-05",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.