Individual provider Active NPI

Lissette Jimenez-Davila, M.D.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • San Juan, PR
National Provider Identifier
1477502441
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
10527 Issued in PR
Practice address
400 Domenech Ave.
Suite 407
San Juan, PR 00918-3704
Phone
(787) 754-3300
Fax
(787) 754-4966
NPI assigned
May 8, 2006
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 10527 PR
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 10527 PR Primary

Addresses

Primary practice location

400 Domenech Ave.
Suite 407
San Juan, PR 00918-3704

Mailing address

400 Domenech Ave.
Suite 407
San Juan, PR 00918-3704
Phone (787) 754-3300

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Somnicare Sleep Institute, PSC CurrentSince May 1, 2013 Accepting new patients
Somnicare Sleep Institute PastSince May 1, 2013 Accepting new patients

Locations

400 Calle Manuel Domenech
Ste 407
San Juan, PR 00918
Phone (787) 754-0330

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1477502441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 DOMENECH AVE.",
            "address_2": "SUITE 407",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183704",
            "telephone_number": "787-754-3300",
            "fax_number": "787-754-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 DOMENECH AVE.",
            "address_2": "SUITE 407",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183704",
            "telephone_number": "787-754-3300",
            "fax_number": "787-754-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ-DAVILA",
        "first_name": "LISSETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PR",
            "license": "10527",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "PR",
            "license": "10527",
            "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 Apr 6, 2017; 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.