Individual provider Active NPI

Ingrid Santisteban Jimenez, SLP

  • Speech-Language Pathologist
  • San Juan, PR
National Provider Identifier
1487709648
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
846 Issued in PR
Practice address
FF3 Calle Poppy
Borinquen Gardens
San Juan, PR 00926-6401
Phone
(787) 562-6710
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 846 PR Primary

Addresses

Primary practice location

FF3 Calle Poppy
Borinquen Gardens
San Juan, PR 00926-6401

Mailing address

FF3 Calle Poppy
Borinquen Gardens
San Juan, PR 00926-6401
Phone (787) 562-6710

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
846PRMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1487709648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FF3 CALLE POPPY",
            "address_2": "BORINQUEN GARDENS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266401",
            "telephone_number": "787-562-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FF3 CALLE POPPY",
            "address_2": "BORINQUEN GARDENS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266401",
            "telephone_number": "787-562-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTISTEBAN JIMENEZ",
        "first_name": "INGRID",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "846",
            "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 Nov 10, 2015; 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.