Julissa Nicole Jaca Castro, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

23630 Issued in PR

Practice address

Carr Num 2 KM 11.6
Bayamon, PR 00960

Phone

(787) 620-8181

NPI assigned

Oct 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Luis Paz Medical Services PSC

  • Specialist
  • Vega Baja, PR
  • NPI 1609191782
  NPD (past)

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745107200000",
    "number": "1588327381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KM 11.7 PR-2 BAYAMON MEDICAL CENTER",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-620-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR NUM 2 KM 11.6",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00960",
            "telephone_number": "787-620-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACA CASTRO",
        "first_name": "JULISSA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2025-04-20",
        "certification_date": "2025-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Island Rehab Center Corp
• IV Home Infusion
• Carlos Antonio Izcoa, D.M.D.
• J.M. Optical LLC
• J8A Orthopedics LLC
• Ignacio Javier Jaca Montijo, M.D.
• Walter E Janer-Martinez, M.D.
• JBM Mental Health Care
• JC Medical Derm LLC
• JCG Medical Emergency Services PSC

• General Practice Physician in Bayamon, PR
• Providers in Bayamon, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.