Individual provider Active NPI

Nilka Dejesus - Gonzalez, MD

  • Pediatric Nephrology Physician
  • Rio Piedras, PR
National Provider Identifier
1356540801
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
17977 Issued in PR
Practice address
Clinica de la Escuela de Medicina
Reparto Metropolitano Shopping
Rio Piedras, PR 00921
Phone
(787) 758-7910
Fax
(787) 625-1966
NPI assigned
Jul 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 17977 PR
Pediatric Nephrology Physician 2080P0210X 17977 PR Primary

Addresses

Primary practice location

Clinica de la Escuela de Medicina
Reparto Metropolitano Shopping
Rio Piedras, PR 00921

Mailing address

PO Box 29134
Nefrologia RCM
San Juan, PR 00929-0134
Phone (787) 756-4010

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
I20130906000464 PR Practitioner - Pediatric MedicinePractitioner - Other (Physician) 4284877408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Puerto Rico School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Ponce de Leon Ave
715 Stop 37.5
San Juan, PR 00918-1000
Phone (787) 771-7934

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
66.19
Improvement activities
40
Cost
73.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17977PRMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Oct 2, 2017 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Oct 2, 2017 Accepting new patients
Departamento de Salud Oficial Past Accepting new patients

Locations

715 Ave Ponce de Leon
Stop 375
San Juan, PR 00917
Phone 7877582000 ext. 3216

715 Ave Ponce de Leon
#37
San Juan, PR 00917
Phone (787) 390-0060

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1184457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1356540801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29134",
            "address_2": "NEFROLOGIA RCM",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009290134",
            "telephone_number": "787-756-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLINICA DE LA ESCUELA DE MEDICINA",
            "address_2": "REPARTO METROPOLITANO SHOPPING",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "00921",
            "telephone_number": "787-758-7910",
            "fax_number": "787-625-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS - GONZALEZ",
        "first_name": "NILKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-15",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "17977",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "PR",
            "license": "17977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Piedras, PR

Sources for this page

Verify at the official NPI Registry.