Individual provider Active NPI

Jose R Renta Monroig, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1164080966
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15029 Issued in PR
Practice address
Bo Monacillos Carr 22 Centro Medico San Juan
San Juan, PR 00935-0001
Phone
(787) 763-4149
NPI assigned
Jun 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 15029 PR Primary

Addresses

Primary practice location

Bo Monacillos Carr 22 Centro Medico San Juan
San Juan, PR 00935-0001

Mailing address

Bo Monacillos Carr 22 Centro Medico San Juan
San Juan, PR 00935-0001
Phone (787) 763-4149

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
I20210127002068 PR Practitioner - General Practice 3375957632 Reassigns benefits to 1 organization
Practice locations: Guaynabo, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15029PRMDPersonal Emergency Response Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Puerto Rico, P.S.C CurrentSince Oct 21, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1164080966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BO MONACILLOS CARR 22 CENTRO MEDICO SAN JUAN",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-763-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO MONACILLOS CARR 22 CENTRO MEDICO SAN JUAN",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-763-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTA MONROIG",
        "first_name": "JOSE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.