Individual provider Active NPI

Rosa L. Haddock-de-Jesus, M.D.

  • Pediatric Critical Care Medicine Physician
  • San Juan, PR
National Provider Identifier
1447699020
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
019292 Issued in PR
Practice address
Hospital Pediatrico Dr Antonio Ortiz
Bo. Monacillos St. 22 Puerto Rico Medical Center
San Juan, PR 00935-0001
Phone
(787) 777-3535
NPI assigned
Jun 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 019292 PR Primary

Addresses

Primary practice location

Hospital Pediatrico Dr Antonio Ortiz
Bo. Monacillos St. 22 Puerto Rico Medical Center
San Juan, PR 00935-0001

Mailing address

HC 2 Box 14772
Gurabo, PR 00778-9808
Phone (787) 688-0691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
019292PRMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Departamento de Salud Oficial 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1447699020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 2 BOX 14772",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007789808",
            "telephone_number": "787-688-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL PEDIATRICO DR ANTONIO ORTIZ",
            "address_2": "BO. MONACILLOS ST. 22 PUERTO RICO MEDICAL CENTER",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-777-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK-DE-JESUS",
        "first_name": "ROSA",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "PR",
            "license": "019292",
            "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 Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.