Individual provider Active NPI

Jan Carlos Ortiz Rosario, MD

  • Retina Specialist (Ophthalmology) Physician
  • Ponce, PR
National Provider Identifier
1386020709
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
19473 Issued in PR
Practice address
Calle Union #91 Esq Calle Sol
Ponce, PR 00730
Phone
(787) 848-5353
Fax
(787) 259-4462
NPI assigned
Aug 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X S5724 TX
General Practice Physician 208D00000X 19473 PR
Retina Specialist (Ophthalmology) Physician 207WX0107X 19473 PR Primary

Addresses

Primary practice location

Calle Union #91 Esq Calle Sol
Ponce, PR 00730

Mailing address

PO Box 7432
Ponce, PR 00732-7432
Phone (787) 848-5353

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
I20220905000194 PR Practitioner - Ophthalmology 8426470741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Ponce School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

91 Calle Un
Ponce, PR 00730-3749
Phone (787) 848-5353

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19473PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Retina LLC Ophthalmology CurrentSince May 13, 2022 Accepting new patients

Locations

91 Calle Sol
Ponce, PR 00730
Phone (787) 844-6709

2970 Ave Emilio Fagot
Ponce, PR 00716
Phone (787) 841-0014

91 Calle Union
Ponce, PR 00730
Phone (787) 382-5195

Interoperability endpoints

  • Direct secure messaging: jortizrosario1818369@direct.texashealth.org

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": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1386020709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7432",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007327432",
            "telephone_number": "787-848-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE UNION #91 ESQ CALLE SOL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-848-5353",
            "fax_number": "787-259-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ ROSARIO",
        "first_name": "JAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-07",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "S5724",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19473",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "PR",
            "license": "19473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.