Individual provider Active NPI

Jaime Jose Bravo Castro, M.D.

  • Ophthalmology Physician
  • San Juan, PR
National Provider Identifier
1386611960
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
6250 Issued in PR
Practice address
1785 Carr 21
Hospital Metropolitano Suite 202
San Juan, PR 00921-3399
Phone
(787) 781-5153
Fax
(787) 793-8341
NPI assigned
Mar 2, 2006
Last updated
Dec 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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 6250 PR Primary

Addresses

Primary practice location

1785 Carr 21
Hospital Metropolitano Suite 202
San Juan, PR 00921-3399

Mailing address

165 Calle Reina Isabel
La Villa de Torrimar
Guaynabo, PR 00969-3284
Phone (787) 781-5153

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
I20120308000530 PR Practitioner - Ophthalmology 6507025673 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Torre del Metropolitano 1789 Carr
21 Suite 311
San Juan, PR 00921
Phone (787) 781-5153

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6250PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grupo Oftalmologia HMLN Ophthalmology Past Accepting new patients

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1386611960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 CALLE REINA ISABEL",
            "address_2": "LA VILLA DE TORRIMAR",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009693284",
            "telephone_number": "787-781-5153",
            "fax_number": "787-793-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 CARR 21",
            "address_2": "HOSPITAL METROPOLITANO SUITE 202",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213399",
            "telephone_number": "787-781-5153",
            "fax_number": "787-793-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO CASTRO",
        "first_name": "JAIME",
        "middle_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "6250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.