Dr. Jaca Montijo CSP

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

13094 Issued in PR

Legal business name

DR. JACA MONTIJO CSP

Doing business as

Instituto de Gastroenterologia Avanzada

Practice address

Metromedical
Suite 903
Bayamon, PR 00959-5065

Phone

(787) 935-7500

Fax

(787) 395-7501

NPI assigned

Sep 17, 2012

Last updated

Mar 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ignacio Jaca, M.D.

Title

President

Phone

(787) 559-5212

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• INSTITUTO DE GASTROENTEROLOGIA AVANZADA Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ignacio Javier Jaca Montijo, M.D.

  • Specialist
  • Bayamon, PR
  • NPI 1477650893

  Gastroenterology

  Medicare reassignment NPD
• Lizmarie Burgos, RPH.

  • Pharmacist
  • Bayamon, PR
  • NPI 1508083080
  NPD

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1730439886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 CARR 2 STE 2903",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009595062",
            "telephone_number": "787-395-7500",
            "fax_number": "787-395-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "METROMEDICAL",
            "address_2": "SUITE 903",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009595065",
            "telephone_number": "787-935-7500",
            "fax_number": "787-395-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JACA MONTIJO CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-17",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "JACA",
        "authorized_official_first_name": "IGNACIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-559-5212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "PR",
            "license": "13094",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "13094",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HY226A",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INSTITUTO DE GASTROENTEROLOGIA AVANZADA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "INSTITUTO DE GASTROENTEROLOGIA AVANZADA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Endoscopy Clinic/Center in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Endoscopy Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.