Active NPI
Miguel A De Jesus, MD, FAAP
- Pediatrics Physician
- San Juan, PR
National Provider Identifier
1124088224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 5765
- Practice address
- Cond Ada Ligia Local B Oficina 4
Ave Ashford 1452
San Juan, PR 00907-1581 - Phone
- (787) 640-7111
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 5765 | PR | Primary |
Addresses
Primary practice location
Cond Ada Ligia Local B Oficina 4
Ave Ashford 1452
San Juan, PR 00907-1581
Mailing address
Calle 1 #10 Extension Alturas de San Patricio
Guaynabo, PR 00968
Phone (787) 725-0909
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160826000259 | PR | Order and Referring Only - Pediatric Medicine | 8820383052 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325635200000",
"number": "1124088224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CALLE 1 #10 EXTENSION ALTURAS DE SAN PATRICIO",
"city": "GUAYNABO",
"state": "PR",
"postal_code": "00968",
"telephone_number": "787-725-0909",
"fax_number": "787-725-0909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "COND ADA LIGIA LOCAL B OFICINA 4",
"address_2": "AVE ASHFORD 1452",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009071581",
"telephone_number": "787-640-7111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JESUS",
"first_name": "MIGUEL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD, FAAP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2012-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PR",
"license": "5765",
"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 Jan 4, 2012; 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.