Individual provider Active NPI

Christine Jimenez, M.D.

  • Surgery Physician
  • Manati, PR
National Provider Identifier
1336383579
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
18672 Issued in PR
Practice address
MMC Medical Plaza
Suite 611
Manati, PR 00674-0000
Phone
(787) 915-7878
Fax
(787) 915-7879
NPI assigned
Apr 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 18672 PR Primary

Addresses

Primary practice location

MMC Medical Plaza
Suite 611
Manati, PR 00674-0000

Mailing address

PO Box 1476
Manati, PR 00674-1476
Phone (787) 915-7878

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
I20140724002445 PR Practitioner - General Surgery 1850517996 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Puerto Rico School of Medicine, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Manati, PR 00674

Professional Plaza
Suite 611
Manati, PR 00674
Phone (787) 621-3700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18672PRMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blessed Surgical Services PSC Surgery CurrentSince Jul 1, 2014 Accepting new patients
Stereotactic Breast Center PSC CurrentSince Mar 22, 2016 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1336383579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1476",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006741476",
            "telephone_number": "787-915-7878",
            "fax_number": "787-915-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC MEDICAL PLAZA",
            "address_2": "SUITE 611",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740000",
            "telephone_number": "787-915-7878",
            "fax_number": "787-915-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-30",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PR",
            "license": "18672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.