Individual provider Active NPI

Carlos E Jimenez, MD

  • Nuclear Medicine Physician
  • San Juan, PR
National Provider Identifier
1609841667
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
License
11046 Issued in PR
Practice address
Ashford Presby Hospital Nuclear Medicine Laboratory
1St Floor , Ashford Ave
San Juan, PR 00907
Phone
(787) 724-3500
Fax
(787) 725-0485
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) Physician 207RS0010X 11046 PR
Nuclear Medicine Physician 207U00000X 11046 PR Primary

Addresses

Primary practice location

Ashford Presby Hospital Nuclear Medicine Laboratory
1St Floor , Ashford Ave
San Juan, PR 00907

Mailing address

35 Juan Borbon St
PMB 130
Guaynabo, PR 00969-5375
Phone (787) 724-3500

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
I20051021000247 PR Practitioner - Nuclear MedicinePractitioner - Internal MedicinePractitioner - Sports Medicine 7416973169 Reassigns benefits to 2 organizations
Practice locations: Rio Piedras, PR; San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Nuclear MedicineAlso: Internal Medicine, Sports Medicine
Education
Ponce School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Patricio MRI and CT Center, P.S.C.Group PAC ID 9436251808, 6 clinicians

Practice addresses (Care Compare)

280 Ave Marginal Kennedy
Guaynabo, PR 00968-1746
Phone (787) 620-5772

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95 of 100Reported as group
Quality
90
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11046PRMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
San Patricio MRI & CT Center, P.S.C. CurrentSince Jan 1, 2015 Accepting new patients
Corporacion Centro Cardiovascular de Puerto Rico Y del Caribe CurrentSince Jan 8, 2015 Accepting new patients
Corporacion Centro Cardiovascular de Puerto Rico Y del Caribe CurrentSince Jan 8, 2015 Accepting new patients
Laboratorio de Medicina Nuclear & Pet Inc Nuclear Medicine Past Accepting new patients
Lab Medicina Nuclear PSC Nuclear Medicine Past Accepting new patients

Locations

280 Ave Marginal Kennedy
Guaynabo, PR 00968
Phone (787) 620-5757

Organizations & group practices 5

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1609841667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 JUAN BORBON ST",
            "address_2": "PMB 130",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009695375",
            "telephone_number": "787-724-3500",
            "fax_number": "787-725-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ASHFORD PRESBY HOSPITAL NUCLEAR MEDICINE LABORATORY",
            "address_2": "1ST FLOOR , ASHFORD AVE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00907",
            "telephone_number": "787-724-3500",
            "fax_number": "787-725-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "CARLOS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "PR",
            "license": "11046",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "PR",
            "license": "11046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.