Organization Active NPI

J.C. Island Lithotripsy LLC

  • Urology Physician
  • Ponce, PR
National Provider Identifier
1386815264
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
J.C. ISLAND LITHOTRIPSY LLC
Practice address
909 Ave Tito Castro Saint Lukes Memorial Hospital Inc
Second Floor in Front of Or
Ponce, PR 00716-4717
Phone
(787) 844-2080
Fax
(787) 840-5390
NPI assigned
Mar 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Authorized official

Name
Mr. Felix Mendoza-Rosa, MD
Title
President
Phone
(787) 844-2080

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary
Lithotripsy Clinic/Center 261QL0400X

Addresses

Primary practice location

909 Ave Tito Castro Saint Lukes Memorial Hospital Inc
Second Floor in Front of Or
Ponce, PR 00716-4717

Mailing address

609 Ave Tito Castro Ste 102
PMB 382
Ponce, PR 00716-0200
Phone (787) 844-2080

Other identifiers 1

IdentifierTypeStateIssuer
038410300MedicaidPR

Other names 1

  • ISLAND LITHOTRIPSY Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL PROOFPOINT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110714000272 PR Part B Supplier - Clinic/Group Practice 3779751904 Receives reassigned benefits from 1 practitioner
Practice locations: Caguas, PR; Cayey, PR; Ponce, PR

National Provider Directory

National Provider Directory

Locations

100 Calle Betances
Caguas, PR 00725
Phone (787) 729-0606

917 Ave Tito Castro
Frnt A
Ponce, PR 00716

917 Ave Tito Castro
#2
Ponce, PR 00716

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1386815264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 AVE TITO CASTRO STE 102",
            "address_2": "PMB 382",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007160200",
            "telephone_number": "787-844-2080",
            "fax_number": "787-840-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 AVE TITO CASTRO SAINT LUKES MEMORIAL HOSPITAL INC",
            "address_2": "SECOND FLOOR IN FRONT OF OR",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164717",
            "telephone_number": "787-844-2080",
            "fax_number": "787-840-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.C. ISLAND LITHOTRIPSY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A",
        "authorized_official_last_name": "MENDOZA-ROSA",
        "authorized_official_first_name": "FELIX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-844-2080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QL0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Lithotripsy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038410300",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PROOFPOINT",
            "affiliation": "N",
            "address_1": "909 Ave Tito Castro Saint Lukes Memorial Hospital Inc",
            "address_2": "Second Floor in Front of OR",
            "city": "Ponce",
            "state": "PR",
            "country_code": "US",
            "postal_code": "007164717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ISLAND LITHOTRIPSY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.