Active NPI
Home Orthopedics PR, LLC
- Prosthetic/Orthotic Supplier
- San Juan, PR
National Provider Identifier
1417692369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Legal business name
- HOME ORTHOPEDICS PR, LLC
- Practice address
- 202 Calle Federico Costa Ste 301
San Juan, PR 00918-1321 - Phone
- (787) 763-1002
- Fax
- (787) 763-1004
- NPI assigned
- May 4, 2022
- Last updated
- May 4, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jesus Gabriel Rodriguez, BOCCP
- Title
- President
- Phone
- (787) 763-1002
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | NU | Primary |
Addresses
Primary practice location
202 Calle Federico Costa Ste 301
San Juan, PR 00918-1321
Mailing address
202 Calle Federico Costa Ste 301
San Juan, PR 00918-1321
Phone (787) 763-1002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221123001375 | PR | DME Supplier - Medical Supply Company | 3375926488 | Practice locations: San Juan, PR |
National Provider Directory
National Provider Directory- Tax ID family
- Home Orthopedics PR LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Mayaguez, PR
- NPI 1326992470
Locations
202 Calle Federico Costa
Ste 301
San Juan, PR 00918
Phone (787) 763-1002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651622400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1651622400000",
"number": "1417692369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 CALLE FEDERICO COSTA STE 301",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009181321",
"telephone_number": "787-763-1002",
"fax_number": "787-763-1004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 CALLE FEDERICO COSTA STE 301",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009181321",
"telephone_number": "787-763-1002",
"fax_number": "787-763-1004"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOME ORTHOPEDICS PR, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-05-04",
"last_updated": "2022-05-04",
"certification_date": "2022-05-04",
"status": "A",
"authorized_official_last_name": "RODRIGUEZ",
"authorized_official_first_name": "JESUS",
"authorized_official_middle_name": "GABRIEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "787-763-1002",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "BOCCP"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.