Individual provider Active NPI

Jose Luis Cruz-Melendez, M.D.

  • Pediatrics Physician
  • Ponce, PR
National Provider Identifier
1154379113
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
7029 Issued in PR
Practice address
2431 Ave Las Americas
Edf. a Porrata Pila Suite 301
Ponce, PR 00717-2113
Phone
(787) 843-3538
Fax
(787) 840-5189
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 7029 PR Primary

Addresses

Primary practice location

2431 Ave Las Americas
Edf. a Porrata Pila Suite 301
Ponce, PR 00717-2113

Mailing address

2431 Las Americas Ave.
Edf. a Porrata Pila Suite 301
Ponce, PR 00717-2115
Phone (787) 843-3538

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141017001371 PR Practitioner - Pediatric Medicine 6204057110 Practice locations: Ponce, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7029PRMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1154379113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 LAS AMERICAS AVE.",
            "address_2": "EDF. A PORRATA PILA SUITE 301",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172115",
            "telephone_number": "787-843-3538",
            "fax_number": "787-840-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 AVE LAS AMERICAS",
            "address_2": "EDF. A PORRATA PILA SUITE 301",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172113",
            "telephone_number": "787-843-3538",
            "fax_number": "787-840-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ-MELENDEZ",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "7029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.