Carlos Roberto Jaen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L4467 Issued in TX

Practice address

4647 Medical Dr
San Antonio, TX 78229-4403

Phone

(210) 592-0400

NPI assigned

Nov 2, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjaen48712@uhssa.direct-ci.com

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.

• University of Texas Health Science Center at San Antonio

  dba UT Health Physicians

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717

  Family Medicine

  Medicare reassignment NPD
• The University of Texas Health Science Center at San Antonio

  dba UT Health San Antonio Multispecialty & Research Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• University of Texas Health Science Center at San Antonio

  dba UT Health Imaging

  • Diagnostic Radiology Physician
  • Boerne, TX
  • NPI 1417921834
  NPD

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285625772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6605 COUNTESS ADRIA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381510",
            "telephone_number": "210-567-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294403",
            "telephone_number": "210-592-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAEN",
        "first_name": "CARLOS",
        "middle_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L4467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145256701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffani Karrin Jacques
• Maria De Jesus Jacquez
• Jade DKR LLC
• Gayatri Jadhav
• Reshma Prashant Jadhav, MD
• Rafaela Paola Jaeschke, LD
• Mitra Jafari, M.D.
• Zulfaqqar M Jaffar, MD
• Salima Jaffer, M.D.
• Alina Jafferbhoy, DMD

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.