Organization Active NPI

Jose Raul Montes Eyes & Facial Rejuvenation, LLC

  • Ophthalmology Physician
  • San Juan, PR
National Provider Identifier
1134593577
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
JOSE RAUL MONTES EYES & FACIAL REJUVENATION, LLC
Practice address
735 Ave. Ponce de Leon Suite 813
Torre Medica Auxilio Mutuo
San Juan, PR 00917
Phone
(787) 777-0003
Fax
(787) 777-0004
NPI assigned
Nov 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Authorized official

Name
Mr. Jose Raul Montes Pagan, M.D.
Title
Presidente-(Owner)
Phone
(787) 777-0003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X PR Primary

Addresses

Primary practice location

735 Ave. Ponce de Leon Suite 813
Torre Medica Auxilio Mutuo
San Juan, PR 00917

Mailing address

735 Ave. Ponce de Leon Suite 813
Torre Medica Auxilio Mutuo
San Juan, PR 00917
Phone (787) 777-0003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161116000866 PR Part B Supplier - Clinic/Group Practice 8921387960 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

735 Ave Ponce de Leon
Ste 813
San Juan, PR 00917
Phone (787) 777-0003

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448236800000",
    "number": "1134593577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 AVE. PONCE DE LEON SUITE 813",
            "address_2": "TORRE MEDICA AUXILIO MUTUO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-777-0003",
            "fax_number": "787-777-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 AVE. PONCE DE LEON SUITE 813",
            "address_2": "TORRE MEDICA AUXILIO MUTUO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-777-0003",
            "fax_number": "787-777-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE RAUL MONTES EYES & FACIAL REJUVENATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A",
        "authorized_official_last_name": "MONTES PAGAN",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "RAUL",
        "authorized_official_title_or_position": "PRESIDENTE-(OWNER)",
        "authorized_official_telephone_number": "787-777-0003",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": null,
            "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 Nov 23, 2015; 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.

Verify at the official NPI Registry.