Individual provider Active NPI

Maria Jose De Jesus Pagan, MD

  • General Practice Physician
  • Manati, PR
National Provider Identifier
1598494262
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23460 Issued in PR
Practice address
Manati Medical Center
Calle Hernandez Carrion
Manati, PR 00674
Phone
(787) 621-3700
NPI assigned
Jun 8, 2022
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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 23460 PR Primary

Addresses

Primary practice location

Manati Medical Center
Calle Hernandez Carrion
Manati, PR 00674

Mailing address

Reparto Curiel a-10
Manati, PR 00674
Phone (787) 236-1083

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
I20250226003915 PR Practitioner - General Practice 1153841689 Practice locations: Manati, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23460PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iasmedical Inc. PastSince Jul 1, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1598494262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "REPARTO CURIEL A-10",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-236-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MANATI MEDICAL CENTER",
            "address_2": "CALLE HERNANDEZ CARRION",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-621-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS PAGAN",
        "first_name": "MARIA",
        "middle_name": "JOSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.