Active NPI
Jennifer Ruiz Boada, MD
- Pediatric Critical Care Medicine Physician
- Rio Piedras, PR
National Provider Identifier
1649727405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 21409
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21409 | Other | PR | STATE 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
| License | State | Type | Specialty |
|---|---|---|---|
| 21409 | PR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
dba Hospital Pediatrico Universitario
- Children's Hospital
- Rio Piedras, PR
- NPI 1174678460
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.