Individual provider Active NPI

Thomas Jimenez, M.D.

  • Adult Medicine Physician
  • Manati, PR
National Provider Identifier
1639287121
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
12343 Issued in PR
Practice address
J24 Calle Elliot Velez
Manati, PR 00674-4697
Phone
(787) 854-5828
NPI assigned
Aug 26, 2006
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 12343 PR
Adult Medicine Physician 207QA0505X 12343 PR Primary

Addresses

Primary practice location

J24 Calle Elliot Velez
Manati, PR 00674-4697

Mailing address

PO Box 2494
Vega Baja, PR 00694-2494
Phone (787) 854-5828

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
I20120718000081 PR Practitioner - Family Practice 8628234739 Reassigns benefits to 1 organization
Practice locations: Manata, PR

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 C-11 Flamboyar
Manata, PR 00674
Phone (787) 854-5828

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medicina Integral Dr. Jimenez CSP Family Medicine CurrentSince Nov 21, 2018 Accepting new patients

Locations

J24 Calle Elliot Velez
Manati, PR 00674
Phone (787) 475-3040

Interoperability endpoints

  • Direct secure messaging: tjimenezhernandez@1397.securemail.prognocis.com

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.

Hospital & facility affiliations 4

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": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1639287121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2494",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006942494",
            "telephone_number": "787-854-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "J24 CALLE ELLIOT VELEZ",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006744697",
            "telephone_number": "787-854-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "12343",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PR",
            "license": "12343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.