Individual provider Active NPI

Antonio Jimenez Chinea, MD

  • Nephrology Physician
  • Guaynabo, PR
National Provider Identifier
1093034084
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
21122 Issued in PR
Practice address
C6 Ave Alejandrino
Guaynabo, PR 00969
Phone
(787) 200-8643
NPI assigned
May 31, 2010
Last updated
Nov 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 21122 PR Primary
Nephrology Physician 207RN0300X MD.206323 LA

Addresses

Primary practice location

C6 Ave Alejandrino
Guaynabo, PR 00969

Mailing address

Urb Prado Alto
Calle 6 #K34
Guaynabo, PR 00966
Phone (787) 200-8643

Other identifiers 2

IdentifierTypeStateIssuer
09189769MedicaidMS
2105213MedicaidLA

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
I20190522001874 PR Practitioner - Nephrology 3577876614 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Puerto Rico Vascular Access Center PSCGroup PAC ID 0941500011, 5 clinicians

Practice addresses (Care Compare)

715 Ave Ponce de Leon
San Juan, PR 00917-5032
Phone (787) 758-3320

87 Calle Jose de Diego
Toa Alta, PR 00953-2415
Phone (787) 870-2367

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.206323LAMDNephrology Physician
21122PRMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jimenez Chinea Renal Care LLC Nephrology CurrentSince Jan 25, 2019 Accepting new patients
Recinto de Ciencias Medicas Nephrology CurrentSince May 20, 2023 Accepting new patients
Recinto de Ciencias Medicas CurrentSince May 20, 2023 Accepting new patients
Puerto Rico Vascular Access Center PSC Nephrology CurrentSince Nov 1, 2019 Accepting new patients
Grupo Medico del Toa Past Accepting new patients

Locations

715 Ave Ponce de Leon
#375
San Juan, PR 00917
Phone (787) 504-1100

715 Ave Ponce de Leon
Ste 1
San Juan, PR 00917
Phone 7877582000 ext. 1391

BO Monacillos Centro Medico De
San Juan, PR 00935
Phone 78775825252379

87 Calle Jose de Diego
Toa Alta, PR 00953
Phone (787) 870-2367

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1093034084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB PRADO ALTO",
            "address_2": "CALLE 6 #K34",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00966",
            "telephone_number": "787-200-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C6 AVE ALEJANDRINO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-200-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ CHINEA",
        "first_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-31",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PR",
            "license": "21122",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "MD.206323",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09189769",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105213",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.