Juan I Medina, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

3623 Issued in PR

Practice address

735 Ponce de Leon Ave
Suite 609
San Juan, PR 00917-5028

Phone

(787) 753-8533

Fax

(787) 758-0373

NPI assigned

Jul 18, 2006

Last updated

Sep 4, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Hato Rey Urology Group

  • Urology Physician
  • San Juan, PR
  • NPI 1639498132
  Authorized official Same address or phone

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1215955034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 PONCE DE LEON AVE",
            "address_2": "SUITE 609",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175028",
            "telephone_number": "787-753-8533",
            "fax_number": "787-758-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 PONCE DE LEON AVE",
            "address_2": "SUITE 609",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175028",
            "telephone_number": "787-753-8533",
            "fax_number": "787-758-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JUAN",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PR",
            "license": "3623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Medina
• Doris G Medina, LND,RD
• Edwin Jose Medina
• Haydee Medina, CLINICAL NURSE SPECI
• Jose A Medina, DMD
• Juan Israel Medina Jr., D.D.S. M.S.
• Juan J Medina, MD
• Luis A Medina, M.D.
• Manuel Medina, M.D.
• Margarita Medina, M.D.

• Urology Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Urology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.