NPIMap

Organization Active NPI

Grupo Intensivo Pediatrico de San Juan

  • Pediatric Critical Care Medicine Physician
  • San Juan, PR
National Provider Identifier
1477537892
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
Legal business name
GRUPO INTENSIVO PEDIATRICO DE SAN JUAN
Practice address
252 Calle San Jorge
Medical Office Building Suite 406
San Juan, PR 00912-3310
Phone
(787) 726-0210
Fax
(787) 728-5136
NPI assigned
Nov 30, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jose R Rodriguez-Santana, MD
Title
President
Phone
(787) 726-0210

Specialties & licenses 1

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

Addresses

Primary practice location

252 Calle San Jorge
Medical Office Building Suite 406
San Juan, PR 00912-3310

Mailing address

252 Calle San Jorge
Medical Office Building Suite 406
San Juan, PR 00912-3310
Phone (787) 726-0210

Other identifiers 1

IdentifierTypeStateIssuer
89351OtherPRTRIPLE S

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000129 PR Part B Supplier - Clinic/Group Practice 3274420815 Receives reassigned benefits from 10 practitioners
Practice locations: Bayamon, PR; Caguas, PR; Hato Rey, PR; Rio Piedras, PR; San Juan, PR

National Provider Directory

National Provider Directory

Locations

252 Calle San Jorge
Ste 406
San Juan, PR 00912
Phone (787) 403-8523

Hospital Cardiovascular Pediatrico
San Juan, PR 00935

Hospital Pediatrico Dr Antonio Ortiz
San Juan, PR 00935

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477537892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 CALLE SAN JORGE",
            "address_2": "MEDICAL OFFICE BUILDING SUITE 406",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009123310",
            "telephone_number": "787-726-0210",
            "fax_number": "787-728-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 CALLE SAN JORGE",
            "address_2": "MEDICAL OFFICE BUILDING SUITE 406",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009123310",
            "telephone_number": "787-726-0210",
            "fax_number": "787-728-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRUPO INTENSIVO PEDIATRICO DE SAN JUAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ-SANTANA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-726-0210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "89351",
            "state": "PR"
        }
    ],
    "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 Aug 22, 2020; 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.