Individual provider Active NPI

Jorge Mendez -Lopez, M.D.

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1205833274
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14861 Issued in PR
Practice address
41 Calle Piscis
Urb. Los Angeles
Carolina, PR 00979-1620
Phone
(787) 791-5712
Fax
(787) 253-3689
NPI assigned
Jul 5, 2005
Last updated
Nov 25, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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 14861 PR Primary

Addresses

Primary practice location

41 Calle Piscis
Urb. Los Angeles
Carolina, PR 00979-1620

Mailing address

1640 Calle Tamesis
El Paraiso
San Juan, PR 00926-2953
Phone (787) 402-3757

Other identifiers 1

IdentifierTypeStateIssuer
14861OtherPRSTATE MEDICAL LICENSE

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
I20031226000210 PR Practitioner - General Practice 9931007168 Reassigns benefits to 1 organization
Practice locations: Trujillo Alto, PR; Carolina, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Bo Las Cuevas Carr 876 KM
Suite 0
Trujillo Alto, PR 00976
Phone (787) 766-2400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14861PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JRML Medical Services LLC General Practice CurrentSince Oct 6, 2023 Accepting new patients
Policlinica del Caribe PSC General Practice PastSince Nov 17, 2014 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1205833274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 CALLE TAMESIS",
            "address_2": "EL PARAISO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009262953",
            "telephone_number": "787-402-3757",
            "fax_number": "787-292-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 CALLE PISCIS",
            "address_2": "URB. LOS ANGELES",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009791620",
            "telephone_number": "787-791-5712",
            "fax_number": "787-253-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ -LOPEZ",
        "first_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "14861",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.