Individual provider Active NPI

Jorge Luis Jimenez, M.D.

  • Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
  • San Juan, PR
National Provider Identifier
1770705360
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Neuroimaging (Psychiatry & Neurology) PhysicianTaxonomy code 2084D0003X
License
4228 Issued in PR
Practice address
Clinica Las Americas
Ave. F. D. Roosevelt #400, Suite 410
San Juan, PR 00918
Phone
(787) 753-6414
Fax
(787) 763-7125
NPI assigned
May 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician 2084D0003X 4228 PR Primary

Addresses

Primary practice location

Clinica Las Americas
Ave. F. D. Roosevelt #400, Suite 410
San Juan, PR 00918

Mailing address

Clinica Las Americas
Ave. F. D. Roosevelt #400, Suite 410
San Juan, PR 00918
Phone (787) 753-6414

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
I20150817000479 PR Order and Referring Only - PsychiatryPractitioner - Psychiatry 2961717277

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4228PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770705360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CLINICA LAS AMERICAS",
            "address_2": "AVE. F. D. ROOSEVELT #400, SUITE 410",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-753-6414",
            "fax_number": "787-763-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLINICA LAS AMERICAS",
            "address_2": "AVE. F. D. ROOSEVELT #400, SUITE 410",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-753-6414",
            "fax_number": "787-763-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084D0003X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": "PR",
            "license": "4228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.