Individual provider Active NPI

Jaime Martinez-Souss, M.D.

  • Gastroenterology Physician
  • Santurce, PR
National Provider Identifier
1063474872
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
8869 Issued in PR
Practice address
328 De Diego Ave
Suite 202 Ponce de Leon Ave.
Santurce, PR 00909-1706
Phone
(787) 723-9025
Fax
(787) 722-1987
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

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
Gastroenterology Physician 207RG0100X 8869 PR Primary

Addresses

Primary practice location

328 De Diego Ave
Suite 202 Ponce de Leon Ave.
Santurce, PR 00909-1706

Mailing address

PO Box 363532
San Juan, PR 00936-3532
Phone (787) 723-9025

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
I20120405000511 PR Practitioner - GastroenterologyPractitioner - Internal Medicine 4981865623 Practice locations: Santurce, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8869PRMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063474872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 363532",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009363532",
            "telephone_number": "787-723-9025",
            "fax_number": "787-722-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 DE DIEGO AVE",
            "address_2": "SUITE 202 PONCE DE LEON AVE.",
            "city": "SANTURCE",
            "state": "PR",
            "postal_code": "009091706",
            "telephone_number": "787-723-9025",
            "fax_number": "787-722-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ-SOUSS",
        "first_name": "JAIME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "8869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santurce, PR

Sources for this page

Verify at the official NPI Registry.