Individual provider Active NPI

Jessica Irizarry, M.T

  • Medical Technologist
  • San Juan, PR
National Provider Identifier
1114196565
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical TechnologistTaxonomy code 246QM0706X
License
1742 Issued in PR
Practice address
283 Ave Domenech
San Juan, PR 00918-3520
Phone
(787) 765-0807
Fax
(787) 993-5936
NPI assigned
Feb 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X 1742 PR Primary

Addresses

Primary practice location

283 Ave Domenech
San Juan, PR 00918-3520

Mailing address

283 Ave Domenech
San Juan, PR 00918-3520
Phone (787) 765-0807

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)
Not enrolled
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
972PRMDChiropractor
1742PRMDMedical Technologist

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1114196565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 AVE DOMENECH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183520",
            "telephone_number": "787-765-0807",
            "fax_number": "787-993-5936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 AVE DOMENECH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183520",
            "telephone_number": "787-765-0807",
            "fax_number": "787-993-5936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRIZARRY",
        "first_name": "JESSICA",
        "credential": "M.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "PR",
            "license": "1742",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 29, 2008; 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.