Individual provider Active NPI

Ernesto Luis Jusino Roman, MD

  • Anesthesiology Physician
  • San German, PR
National Provider Identifier
1336203090
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
13524 Issued in PR
Practice address
2 Calle Carro
Hospital de la Concepcion 2ND Floor
San German, PR 00683-4074
Phone
(787) 892-1860
Fax
(787) 892-6972
NPI assigned
Dec 20, 2006
Last updated
Jan 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 13524 PR Primary

Addresses

Primary practice location

2 Calle Carro
Hospital de la Concepcion 2ND Floor
San German, PR 00683-4074

Mailing address

PO Box 66
San German, PR 00683-0066
Phone (787) 892-6972

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
I20050204000020 PR Practitioner - Anesthesiology 9537110887 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Anesthesia Associates LLC CurrentSince Jun 1, 2023 Accepting new patients
Dream Anesthesia LLC Anesthesiology CurrentSince Sep 1, 2024 Accepting new patients
Hospital Damas Inc Current Accepting new patients
SG Blood Saver, Inc Past Accepting new patients

Locations

2213 Ponce Byp
Ponce, PR 00717
Phone (787) 368-7802

2500 Calle Obispado
Ponce, PR 00716
Phone (787) 371-1915

Organizations & group practices 4

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1336203090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006830066",
            "telephone_number": "787-892-6972",
            "fax_number": "787-892-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CALLE CARRO",
            "address_2": "HOSPITAL DE LA CONCEPCION 2ND FLOOR",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006834074",
            "telephone_number": "787-892-1860",
            "fax_number": "787-892-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSINO ROMAN",
        "first_name": "ERNESTO",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PR",
            "license": "13524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

Verify at the official NPI Registry.