Jesse Lee Hernandez Rodriguez, MD
Individual provider Active NPI General Practice Physician · Hormigueros, PR
NPI 1508518895 · NPPES record last updated Feb 1, 2022
Key facts
- NPI
- 1508518895
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 22605 (PR)
- Practice address
- Urbanizacion Estancias del Rio 610
Calle Yaguez
Hormigueros, PR 00660 - Phone
- (787) 629-1560
- NPI assigned
- Jan 19, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220503000772 | PR | Practitioner - General Practice | 7214324623 |
Reassigns benefits to 1 organization Practice locations: Fajardo, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatrix Medical Group of Puerto Rico, P.S.C | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 22605 | PR | Yes |
Addresses
Primary practice location
Urbanizacion Estancias del Rio 610
Calle Yaguez
Hormigueros, PR 00660
Mailing address
Urbanizacion Estancias del Rio 610
Calle Yaguez
Hormigueros, PR 00660
Phone (787) 629-1560
Other providers in Hormigueros, PR
- Ingrid Gonzalez
- Josue A Gonzalez
- Norman Osvaldo Gonzalez
- Ashley Ann Gordils Quiles
- Maria C. Guzman-Duran
- Hogar San Jose
- Hospital de la Concepcion Inc
- Abel Irizarry-Resto
- Jeannette S. Troche
- Luz M Jimenez Morales
All providers in Hormigueros, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.