Individual provider Active NPI

Juan A Jurado, M.D.

  • Ophthalmology Physician
  • Fajardo, PR
National Provider Identifier
1366633315
Registry record updated May 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
3608 Issued in PR
Practice address
Ave General Valero 375
Suite 106
Fajardo, PR 00738-0669
Phone
(787) 863-3040
NPI assigned
Aug 6, 2007
Last updated
May 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 3608 PR Primary

Addresses

Primary practice location

Ave General Valero 375
Suite 106
Fajardo, PR 00738-0669

Mailing address

PO Box 669
Fajardo, PR 00738-0669
Phone (787) 863-3040

Other identifiers 1

IdentifierTypeStateIssuer
94766OtherPRTRIPLE S PIN

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
I20080423000631 PR Practitioner - Ophthalmology 4688752132 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Juan a Jurado C S P Ophthalmology CurrentSince May 2, 2008 Accepting new patients

Locations

375 Ave General Valero
Ste 107
Fajardo, PR 00738
Phone (787) 860-5882

Organizations & group practices 1

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1366633315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007380669",
            "telephone_number": "787-863-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE GENERAL VALERO 375",
            "address_2": "SUITE 106",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007380669",
            "telephone_number": "787-863-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURADO",
        "first_name": "JUAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "3608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S PIN",
            "identifier": "94766",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

Verify at the official NPI Registry.