Individual provider Active NPI

Jose C Jimenez, MD

  • Gastroenterology Physician
  • San Juan, PR
National Provider Identifier
1508851049
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
7165 Issued in PR
Practice address
735 Ave Ponce de Leon Suite 809
Torre Medica Auxilio Mutuo
San Juan, PR 00917-5031
Phone
(787) 274-1282
Fax
(787) 764-0898
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 7165 PR Primary

Addresses

Primary practice location

735 Ave Ponce de Leon Suite 809
Torre Medica Auxilio Mutuo
San Juan, PR 00917-5031

Mailing address

735 Ave Ponce de Leon Ste 809
Torre Medica Auxilio Mutuo
San Juan, PR 00917-5031
Phone (787) 274-1282

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
I20120326000741 PR Practitioner - Gastroenterology 8022015379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Puerto Rico School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hato Rey Medical Gastro,CSPGroup PAC ID 6204833551, 3 clinicians

Practice addresses (Care Compare)

735 Ave Ponce de Leon
Suite 809
San Juan, PR 00917-5031
Phone (787) 274-1282

Hospital & facility affiliations

  • Auxilio Mutuo Hospital Hospital, San Juan, PR, CCN 400016

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy70
Upper gastrointestinal (GI) endoscopy for acid reflux66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7365PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hato Rey Medical Gastro,CSP Gastroenterology CurrentSince Oct 1, 2000 Accepting new patients

Locations

735 Ave Ponce de Leon
Ste 809
San Juan, PR 00917
Phone (787) 274-1282

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1508851049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON STE 809",
            "address_2": "TORRE MEDICA AUXILIO MUTUO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175031",
            "telephone_number": "787-274-1282",
            "fax_number": "787-764-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON SUITE 809",
            "address_2": "TORRE MEDICA AUXILIO MUTUO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175031",
            "telephone_number": "787-274-1282",
            "fax_number": "787-764-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "JOSE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "7165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.