Individual provider Active NPI

Jose Ricardo De Leon-Jimenez, M.D.

  • Otolaryngology Physician
  • Carolina, PR
National Provider Identifier
1376506071
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
12876 Issued in PR
Practice address
Plaza Carolina Mall
Tercer Nivel Suite 11
Carolina, PR 00983
Phone
(787) 776-1511
Fax
(787) 776-1531
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 12876 PR Primary

Addresses

Primary practice location

Plaza Carolina Mall
Tercer Nivel Suite 11
Carolina, PR 00983

Mailing address

1357 Ave Ashford
PMB 428
San Juan, PR 00907-2035
Phone (787) 776-1511

Other practice location 1

Plaza Las Americas
Torre de Plaza Suite 907
San Juan, PR 00918-1581
Phone (787) 281-1200

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
I20080811000488 PR Practitioner - Otolaryngology 4183697675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Puerto Rico School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Plaza Carolina Mall
Tercer Nivel Suite 11
Carolina, PR 00983-0001
Phone (787) 776-1511

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Condado Otolaryngology PSC Otolaryngology CurrentSince Aug 11, 2008 Accepting new patients

Locations

1452 Ave Ashford
Ste 407
San Juan, PR 00907
Phone (787) 281-1200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1376506071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 AVE ASHFORD",
            "address_2": "PMB 428",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009072035",
            "telephone_number": "787-776-1511",
            "fax_number": "787-785-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PLAZA CAROLINA MALL",
            "address_2": "TERCER NIVEL SUITE 11",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00983",
            "telephone_number": "787-776-1511",
            "fax_number": "787-776-1531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Plaza Las Americas",
            "address_2": "Torre de Plaza Suite 907",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009181581",
            "country_code": "US",
            "telephone_number": "787-281-1200",
            "fax_number": "787-811-2042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LEON-JIMENEZ",
        "first_name": "JOSE",
        "middle_name": "RICARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PR",
            "license": "12876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.