Organization Active NPI

J.E.R.I. Cardiomed, P.S.C.

  • Cardiovascular Disease Physician
  • Guaynabo, PR
National Provider Identifier
1457526782
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
12297 Issued in PR
Legal business name
J.E.R.I. CARDIOMED, P.S.C.
Practice address
N7 Calle 18 Urb Oasis Gardens
Guaynabo, PR 00969
Phone
(787) 766-0466
NPI assigned
Apr 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Dr. Jose Enrique Rivera IrizarryNPI 1851379606
Title
President
Phone
(787) 766-0466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 12297 PR Primary

Addresses

Primary practice location

N7 Calle 18 Urb Oasis Gardens
Guaynabo, PR 00969

Mailing address

N7 Calle 18 Urb Oasis Gardens
Guaynabo, PR 00969
Phone (787) 766-0466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151027000505 PR Part B Supplier - Clinic/Group Practice 1759690167 Receives reassigned benefits from 1 practitioner
Practice locations: Arroyo, PR; Cidra, PR; San Juan, PR

National Provider Directory

National Provider Directory

Locations

100 Ave El Jibaro
Cidra, PR 00739
Phone (787) 271-2070

708 Ave Ponce de Leon
Ste 101
San Juan, PR 00918
Phone (787) 766-0469

Practitioners & affiliated clinicians

Practitioners 3

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": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1457526782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N7 CALLE 18 URB OASIS GARDENS",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-766-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N7 CALLE 18 URB OASIS GARDENS",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-766-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.E.R.I. CARDIOMED, P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "RIVERA IRIZARRY",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ENRIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-766-0466",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PR",
            "license": "12297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.