Jose Miguel De Jesus, MD, OD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

21104 Issued in PR

Practice address

1341 Calle Aldea Apt TH1
San Juan, PR 00907-2320

Phone

(787) 905-3772

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Primary Health LLC

  • Optometrist
  • Naguabo, PR
  • NPI 1235837527
  NPD Authorized official
• Jose de Jesus Dba Paseos Medical

  • General Practice Physician
  • San Juan, PR
  • NPI 1508781154

  Optometrist

  NPD (past) Authorized official
• Dr. Rafael a. Codinach, D.C. Inc.

  • Chiropractor
  • Doral, FL
  • NPI 1528697356
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1114948874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 SIERRA MORENA",
            "address_2": "181 PB LA CUMBRE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009260001",
            "telephone_number": "787-905-3772",
            "fax_number": "787-705-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 CALLE ALDEA APT TH1",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009072320",
            "telephone_number": "787-905-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "JOSE",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "MD, OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "194",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "21104",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charityn De Jesus
• Clara E De Jesus, DMD
• Coraima De Jesus
• Georgette M. De Jesus, MD
• Glendaly De Jesus, PHARM D
• Julio Victor De Jesus, D.M.D.
• Luz Maryann De Jesus
• Maria De Los Angeles De Jesus, PH.D.
• Melissa De Jesus
• Miguel A De Jesus, MD, FAAP

• General Practice Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.