Jellytza Maldonado, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

12119 Issued in PR

Practice address

1225 Ave Ponce de Leon Ste 106
Ponce de Leon Ave
San Juan, PR 00907-3951

Phone

(787) 250-0852

Fax

(787) 250-0852

NPI assigned

Nov 14, 2005

Last updated

Feb 24, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jellytza.maldonadorondon.p1@direct.vitacare.nextgenshare.com

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.

• Grupo Medico San Carlos

  • Clinic/Center
  • San Juan, PR
  • NPI 1356506844
  NPD (past)

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1316928625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 AVE PONCE DE LEON STE 106",
            "address_2": "PONCE DE LEON AVE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009073951",
            "telephone_number": "787-250-0852",
            "fax_number": "787-250-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 AVE PONCE DE LEON STE 106",
            "address_2": "PONCE DE LEON AVE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009073951",
            "telephone_number": "787-250-0852",
            "fax_number": "787-250-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "JELLYTZA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Concepcin Maldonado, M.D.
• Cynthia Maldonado, M.S., SLP
• Emmanuelle Maldonado Sr., S.W.C
• Felix Maldonado
• Jackeline Maldonado, RN, MSN'S
• Jonathan Maldonado
• Juan Mario Maldonado, M.D.
• Leslie E Maldonado, PH D
• Luz E Maldonado
• Lyssette J Maldonado, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.