JC Professional Medical Services, PSC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

16022 Issued in PR

Legal business name

JC PROFESSIONAL MEDICAL SERVICES, PSC

Practice address

Carr. 931 KM 5.4
Bo.Navarro
Gurabo, PR 00778

Phone

(787) 743-1985

Fax

(787) 744-6276

NPI assigned

Jul 23, 2008

Organization subpart

No

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

Authorized official

Name

Julio Domingo Cordero Sepulveda, MD

Title

General Physician

Phone

(787) 743-1985

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 2

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

• Julio D Cordero

  • General Practice Physician
  • Gurabo, PR
  • NPI 1134190655
  Medicare reassignment NPD
• Oriana Heredia Cruz, MD

  • General Practice Physician
  • San Juan, PR
  • NPI 1336923788
  NPD (past)

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264550400000",
    "number": "1144485632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "698 VEREDAS DE LOS CEDROS",
            "address_2": "VEREDAS",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-743-1985",
            "fax_number": "787-744-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 931 KM 5.4",
            "address_2": "BO.NAVARRO",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-743-1985",
            "fax_number": "787-744-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JC PROFESSIONAL MEDICAL SERVICES, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2010-01-27",
        "status": "A",
        "authorized_official_last_name": "CORDERO SEPULVEDA",
        "authorized_official_first_name": "JULIO",
        "authorized_official_middle_name": "DOMINGO",
        "authorized_official_title_or_position": "GENERAL PHYSICIAN",
        "authorized_official_telephone_number": "787-743-1985",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "16022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENCE",
            "identifier": "16022",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Isla Medical Services CSP
• Jesmar Health Services
• Jason Jose Jimenez Ocasio, M.D.
• Jireh Equipment Services
• KR Gurabo Inc. (Farmacia del Pueblo)
• Laboratorio Clinico Borinquen-Gurabo Plaza

• General Practice Physician in Gurabo, PR
• Providers in Gurabo, 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 Jan 27, 2010; 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.