Individual provider Active NPI

Juan Antonio Raya Jr., M.D.

  • General Practice Physician
  • Aibonito, PR
National Provider Identifier
1699212175
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19547 Issued in PR
Practice address
Carretera 728, Calle Jose C. Vazquez,
Hospital General Menonita de Aibonito Departamento de
Aibonito, PR 00705
Phone
(917) 523-5909
NPI assigned
Jan 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 19547 PR Primary

Addresses

Primary practice location

Carretera 728, Calle Jose C. Vazquez,
Hospital General Menonita de Aibonito Departamento de
Aibonito, PR 00705

Mailing address

2364 Blvd Luis a Ferre
Cond. University Suites Apartment 602
Ponce, PR 00717-0753
Phone (917) 523-5909

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
I20171114001893 PR Practitioner - General Practice 3779849393 Reassigns benefits to 1 organization
Practice locations: Aibonito, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19547PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Menonita de Cayey CurrentSince Sep 3, 2019 Accepting new patients
Hospital Menonita de Cayey General Practice CurrentSince Sep 3, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699212175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 BLVD LUIS A FERRE",
            "address_2": "COND. UNIVERSITY SUITES APARTMENT 602",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170753",
            "telephone_number": "917-523-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 728, CALLE JOSE C. VAZQUEZ,",
            "address_2": "HOSPITAL GENERAL MENONITA DE AIBONITO DEPARTAMENTO DE",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "917-523-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYA",
        "first_name": "JUAN",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aibonito, PR

Sources for this page

Verify at the official NPI Registry.