Active NPI
Omar Antonio Crespo Jimenez, MD
- General Practice Physician
- Aguadilla, PR
National Provider Identifier
1730666827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 21040
- Practice address
- 503 Urb Vista Verde
Aguadilla, PR 00603-6458 - Phone
- (939) 366-4563
- NPI assigned
- Jul 23, 2018
- Last updated
- May 5, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 21040 | PR | Primary |
Addresses
Primary practice location
503 Urb Vista Verde
Aguadilla, PR 00603-6458
Mailing address
PO Box 4465
Aguadilla, PR 00605-4465
Phone (939) 366-4563
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21040 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Susoni Health Community Services Corp | Past | Accepting new patients | |
| Platinum Emergency Physicians, PSC | Past | Accepting new patients | |
| Dr Susoni Health Community Services Corp | Past | Accepting new patients |
Organizations & group practices 4
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.
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- NPI 1245775089
-
dba Hospital Pavia Arecibo
- Anesthesiology Physician
- Arecibo, PR
- NPI 1053945022
-
dba Hospital Pavia Arecibo
- General Acute Care Hospital
- Arecibo, PR
- NPI 1972531218
-
- Emergency Medicine Physician
- Arecibo, PR
- NPI 1285980052
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777939200000",
"number": "1730666827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4465",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "006054465",
"telephone_number": "939-366-4563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 URB VISTA VERDE",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "006036458",
"telephone_number": "939-366-4563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRESPO JIMENEZ",
"first_name": "OMAR",
"middle_name": "ANTONIO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-23",
"last_updated": "2026-05-05",
"certification_date": "2026-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "21040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aguadilla, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.