Individual provider Active NPI

Jennifer Ruiz Boada, MD

  • Pediatric Critical Care Medicine Physician
  • Rio Piedras, PR
National Provider Identifier
1649727405
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
21409 Issued in PR
Practice address
Hospital Pediatrico Universitario Dr Antonio Ortiz
Carretera 22 Barrio Monacillos, Centro Medico
Rio Piedras, PR 00935
Phone
(787) 474-0333
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 21409 PR
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Critical Care Medicine Physician 2080P0203X 21409 PR Primary

Addresses

Primary practice location

Hospital Pediatrico Universitario Dr Antonio Ortiz
Carretera 22 Barrio Monacillos, Centro Medico
Rio Piedras, PR 00935

Mailing address

1506 Ave Ashford Apt 602
San Juan, PR 00911-1168
Phone (787) 292-9994

Other identifiers 1

IdentifierTypeStateIssuer
21409OtherPRSTATE MEDICAL LICENSE OF PUERTO RICO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21409PRMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Departamento de Salud Oficial Past 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": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1649727405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 AVE ASHFORD APT 602",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009111168",
            "telephone_number": "787-292-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL PEDIATRICO UNIVERSITARIO DR ANTONIO ORTIZ",
            "address_2": "CARRETERA 22 BARRIO MONACILLOS, CENTRO MEDICO",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "00935",
            "telephone_number": "787-474-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ BOADA",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "21409",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "PR",
            "license": "21409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE OF PUERTO RICO",
            "identifier": "21409",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Piedras, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.