Active NPI
Jessica R Lebron, MHSN, RD, LDN
- Registered Dietitian
- Hato Rey, PR
National Provider Identifier
1104586783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 002192
- Practice address
- 715 Ave Ponce de Leon
Hato Rey, PR 00917-5032 - Phone
- (787) 758-2000
- NPI assigned
- Dec 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 002192 | PR | Primary |
Addresses
Primary practice location
715 Ave Ponce de Leon
Hato Rey, PR 00917-5032
Mailing address
Urb Villa Contessa
F24 Calle Aragon
Bayamon, PR 00956-2778
Phone (469) 449-3634
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002192 | PR | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. | Current | Accepting new patients | |
| Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. | Nutritionist | Current | Accepting new patients |
Locations
715 Ave Ponce de Leon
San Juan, PR 00917
Phone 7877582000 ext. 3216
715 Ave Ponce de Leon
Stop 375
San Juan, PR 00917
Phone 7877582000 ext. 3216
715 Ave Ponce de Leon
#37
San Juan, PR 00917
Phone (787) 296-0870
Organizations & group practices 2
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.
-
- Nutritionist
- San Juan, PR
- NPI 1356771158
-
- Rehabilitation Clinic/Center
- San Juan, PR
- NPI 1992369615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640217600000",
"number": "1104586783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB VILLA CONTESSA",
"address_2": "F24 CALLE ARAGON",
"city": "BAYAMON",
"state": "PR",
"postal_code": "009562778",
"telephone_number": "469-449-3634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 AVE PONCE DE LEON",
"city": "HATO REY",
"state": "PR",
"postal_code": "009175032",
"telephone_number": "787-758-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBRON",
"first_name": "JESSICA",
"middle_name": "R",
"credential": "MHSN, RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-23",
"last_updated": "2021-12-23",
"certification_date": "2021-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "002192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hato Rey, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.