Individual provider Active NPI

Jean Pierre Carrasquillo

  • Surgery Physician
  • Mayaguez, PR
National Provider Identifier
1467695239
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
18865 Issued in PR
Practice address
349 Ave Hostos
Medical Emporium II Suite a-29
Mayaguez, PR 00680-1509
Phone
(787) 690-2157
NPI assigned
Apr 9, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 18865 PR Primary

Addresses

Primary practice location

349 Ave Hostos
Medical Emporium II Suite a-29
Mayaguez, PR 00680-1509

Mailing address

6400 Ave Isla Verde
Apt. 4C West
Carolina, PR 00979-7161
Phone (787) 314-2325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141029000990 PR Practitioner - General Surgery 0547481954 Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Ponce School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

410 Ave Hostos
Mayaguez, PR 00682-1560
Phone (787) 381-7469

Hospital & facility affiliations

  • Mayaguez Medical Center Dr Ramon Emeterio Betances Hospital, Mayaguez, PR, CCN 400103

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)11
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux17
Removal of tissue16
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18865PRMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MMCW Family Medical Center LLC PastSince Sep 1, 2021 Accepting new patients
MMR Instituto de Medicina de Familia del Oeste CSP Past Accepting new patients
Mayaguez Medical Center Dr Ramon Emeterio Betances Inc Past Accepting new patients
Pediatric & General Surgery LLC Surgery PastSince Oct 4, 2020 Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1467695239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 AVE ISLA VERDE",
            "address_2": "APT. 4C WEST",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009797161",
            "telephone_number": "787-314-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 AVE HOSTOS",
            "address_2": "MEDICAL EMPORIUM II SUITE A-29",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801509",
            "telephone_number": "787-690-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASQUILLO",
        "first_name": "JEAN",
        "middle_name": "PIERRE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PR",
            "license": "18865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.