Individual provider Active NPI

Ceciliana De Andino de Jesus, MD

  • Urology Physician
  • San Juan, PR
National Provider Identifier
1689820359
Registry record updated Aug 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
19352 Issued in PR
Practice address
University District Hospital
Medical Center Udh 2 PO 2116
San Juan, PR 00922-2116
Phone
(787) 754-0101
NPI assigned
Aug 14, 2008
Last updated
Aug 2, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 19352 PR Primary

Addresses

Primary practice location

University District Hospital
Medical Center Udh 2 PO 2116
San Juan, PR 00922-2116

Mailing address

University District Hospital
Medical Center Udh 2 PO 2116
San Juan, PR 00922-2116
Phone (787) 754-0101

Other names 1

  • Ceciliana De Andino de Jesus Former name

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
I20170922000464 PR Practitioner - Urology 2769756287 Reassigns benefits to 1 organization
Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Puerto Rico Urology Group LLCGroup PAC ID 7012230519, 14 clinicians

Practice addresses (Care Compare)

103 Calle de Diego E
Mayaguez, PR 00680-4863
Phone (787) 652-4205

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19352PRMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Puerto Rico Urology Group LLC Urology CurrentSince Dec 28, 2017 Accepting new patients

Locations

103 Calle de Diego E
Mayaguez, PR 00680
Phone (787) 652-4205

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": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501632000000",
    "number": "1689820359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY DISTRICT HOSPITAL",
            "address_2": "MEDICAL CENTER UDH 2 PO 2116",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009222116",
            "telephone_number": "787-754-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY DISTRICT HOSPITAL",
            "address_2": "MEDICAL CENTER UDH 2 PO 2116",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009222116",
            "telephone_number": "787-754-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ANDINO DE JESUS",
        "first_name": "CECILIANA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2017-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PR",
            "license": "19352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CECILIANA",
            "last_name": "DE ANDINO DE JESUS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.