Individual provider Active NPI

Fermin L De Jesus, MD

  • General Practice Physician
  • Arroyo, PR
National Provider Identifier
1710458674
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
21180 Issued in PR
Practice address
Carr 753 KM 6.4
Bo Yaurel Sector Palmarejo
Arroyo, PR 00714
Phone
(787) 354-2907
NPI assigned
Dec 17, 2018
Last updated
Dec 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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 21180 PR Primary

Addresses

Primary practice location

Carr 753 KM 6.4
Bo Yaurel Sector Palmarejo
Arroyo, PR 00714

Mailing address

HC 1 Box 6076
Arroyo, PR 00714-9607
Phone (787) 354-2907

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
I20190815001169 PR Practitioner - General Practice 3476869488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

99 Calle Guillermo Riefkhol
Patillas, PR 00723-2838

99 Calle Riefkohl
Patillas, PR 00723-2838
Phone (787) 839-4320

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Servicios Primarios de Salud de Patillas Inc. CurrentSince Jun 21, 2019 Accepting new patients
Centro Servicios Primarios de Salud de Patillas Inc. CurrentSince Jun 21, 2019 Accepting new patients
Centro Servicios Primarios de Salud de Patillas Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: fermin.dejesus@cspsp.directbygreenway.com

Organizations & group practices 3

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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1710458674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 6076",
            "city": "ARROYO",
            "state": "PR",
            "postal_code": "007149607",
            "telephone_number": "787-354-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 753 KM 6.4",
            "address_2": "BO YAUREL SECTOR PALMAREJO",
            "city": "ARROYO",
            "state": "PR",
            "postal_code": "00714",
            "telephone_number": "787-354-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "FERMIN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo, PR

Sources for this page

Verify at the official NPI Registry.