Individual provider Active NPI

Jorge A Mundo, MD

  • Rheumatology Physician
  • Humacao, PR
National Provider Identifier
1265593222
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
8410 Issued in PR
Practice address
Calle Antonio Lopez #114
Humacao, PR 00791
Phone
(787) 850-6005
Fax
(787) 852-5449
NPI assigned
Dec 13, 2006
Last updated
Nov 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 8410 PR Primary

Addresses

Primary practice location

Calle Antonio Lopez #114
Humacao, PR 00791

Mailing address

PO Box 1447
Juncos, PR 00777-1447
Phone (787) 850-6005

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
I20081027000319 PR Practitioner - RheumatologyPractitioner - Internal Medicine 8325106917 Reassigns benefits to 1 organization
Practice locations: Caguas, PR; Humacao, PR

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Calle Antonio Lopez No
Suite 114
Humacao, PR 00791-4249
Phone (787) 850-6005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8410PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Servicios de Reumatologia PSC CurrentSince Oct 3, 1988 Accepting new patients

Locations

61 Calle Dr Goyco
Caguas, PR 00725
Phone (787) 286-3546

114 Calle Antonio Lopez S
Humacao, PR 00791
Phone (787) 850-6005

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, 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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1265593222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1447",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007771447",
            "telephone_number": "787-850-6005",
            "fax_number": "787-852-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE ANTONIO LOPEZ #114",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-850-6005",
            "fax_number": "787-852-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDO",
        "first_name": "JORGE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PR",
            "license": "8410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.