Individual provider Active NPI

Maria Isabel De Jesus, MD

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1508473620
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22007 Issued in PR
Practice address
Ave Roberto Clemente Bloque 124
No. 8 Villa Carolina
Carolina, PR 00985-0098
Phone
(407) 732-3739
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 22007 PR Primary

Addresses

Primary practice location

Ave Roberto Clemente Bloque 124
No. 8 Villa Carolina
Carolina, PR 00985-0098

Mailing address

881 Calle Manuel Guerra
San Juan, PR 00924-2533
Phone (787) 750-6525

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
I20201130000661 PR Practitioner - General Practice 3971914714 Practice locations: Carolina, PR

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1508473620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 CALLE MANUEL GUERRA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009242533",
            "telephone_number": "787-750-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE ROBERTO CLEMENTE BLOQUE 124",
            "address_2": "NO. 8 VILLA CAROLINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009850098",
            "telephone_number": "407-732-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "MARIA",
        "middle_name": "ISABEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.