Individual provider Active NPI

Jaime Marrero Russe, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Arecibo, PR
National Provider Identifier
1619053519
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
07949 Issued in PR
Practice address
55 Calle Palma
Arecibo, PR 00612-4526
Phone
(787) 855-8624
Fax
(787) 650-1030
NPI assigned
Oct 31, 2006
Last updated
Jun 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 07949 PR Primary

Addresses

Primary practice location

55 Calle Palma
Arecibo, PR 00612-4526

Mailing address

PO Box 4215
Vega Baja, PR 00694-4215
Phone (787) 855-8624

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
I20040331001255 PR Practitioner - Physical Medicine and Rehabilitation 2567454432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University Central del Caribe Escuela de Medicina, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carretera 2 KM
7 Health South Manati
Manati, PR 00674
Phone (787) 751-8286

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7949PRMDClinical Social Worker
07949PRMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Servicios Rehabilitacion del Norte, CSP Physical Medicine & Rehabilitation CurrentSince Jan 14, 2004 Accepting new patients

Locations

55 Calle Palma
Arecibo, PR 00612
Phone (787) 619-6667

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1619053519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4215",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006944215",
            "telephone_number": "787-855-8624",
            "fax_number": "787-650-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CALLE PALMA",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006124526",
            "telephone_number": "787-855-8624",
            "fax_number": "787-650-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO RUSSE",
        "first_name": "JAIME",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PR",
            "license": "07949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.