Organization Active NPI

Home Orthopedics PR, LLC

  • Prosthetic/Orthotic Supplier
  • San Juan, PR
National Provider Identifier
1417692369
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
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, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20221123001375 PR DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company With Prosthetic PersonnelDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic PersonnelDME Supplier - Pedorthic PersonnelDME Supplier - Medical Supply Company With Pedorthic Personnel 3375926488 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Tax ID family
Home Orthopedics PR LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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.

Verify at the official NPI Registry.