Individual provider Active NPI

Marc A Jerome, MD

  • Gynecology Physician
  • Christiansted, VI
National Provider Identifier
1477680114
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
1041 Issued in VI
Practice address
184 Ruby Plaza
Christiansted, VI 00820
Phone
(340) 778-5777
Fax
(340) 778-3161
NPI assigned
Feb 28, 2007
Last updated
Jun 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 1041 VI Primary

Addresses

Primary practice location

184 Ruby Plaza
Christiansted, VI 00820

Mailing address

PO Box 25537
Christiansted, VI 00824-1537
Phone (340) 713-9002

Other identifiers 1

IdentifierTypeStateIssuer
VI LICENSEOtherVI1041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
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
I20080220000667 VI Practitioner - Obstetrics/Gynecology 8921182536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1962
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3500 Estate Richmond
Christiansted, VI 00820-4370

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1041VIMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Health Govt of the Virgin Islands CurrentSince Aug 7, 2009 Accepting new patients
Department of Health, Govt of VI/MCH Clinic Elaine Co Past Accepting new patients
Lesser Antilles Nephrology Past Accepting new patients

Locations

3500 Estate Richmond
St Croix, VI 00820
Phone (340) 718-1311

Organizations & group practices 3

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1477680114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25537",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008241537",
            "telephone_number": "340-713-9002",
            "fax_number": "340-713-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 RUBY PLAZA",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "00820",
            "telephone_number": "340-778-5777",
            "fax_number": "340-778-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME",
        "first_name": "MARC",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "VI",
            "license": "1041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1041",
            "identifier": "VI LICENSE",
            "state": "VI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiansted, VI

Sources for this page

Verify at the official NPI Registry.