Individual provider Active NPI

Ediberto III Rodriguez de Jesus, AUD

  • Audiologist
  • Toa Alta, PR
National Provider Identifier
1780367524
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1033 Issued in PR
Practice address
Haciendad del Caribe
Calle Yuquiyu I-9
Toa Alta, PR 00953
Phone
(787) 293-7485
NPI assigned
Aug 9, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1033 PR Primary

Addresses

Primary practice location

Haciendad del Caribe
Calle Yuquiyu I-9
Toa Alta, PR 00953

Mailing address

RR 7 Box 17141
Toa Alta, PR 00953-8844
Phone (787) 293-7485

Other practice location 1

Carr 651 KM 5.2 BO Dominguito
Arecibo, PR 00612
Phone (787) 293-7485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231129000253 PR Practitioner - Qualified Audiologist 2567819055 Reassigns benefits to 2 organizations
Practice locations: Arecibo, PR

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hearing Center LLCGroup PAC ID 0648719872, 4 clinicians

Practice addresses (Care Compare)

Urb Rio Piedras Heights
1726 Ave Lomas Verdes
San Juan, PR 00926
Phone (787) 766-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1033PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Voice & Sinus Institute PSC CurrentSince Aug 15, 2024 Accepting new patients
Hearing Center LLC Audiologist CurrentSince Aug 15, 2024 Accepting new patients
Centro Audiologico E Interdisciplinario, Isamar Gonzalez, Inc. Audiologist Past Accepting new patients

Locations

735 Ave Ponce de Leon
Ste 214
San Juan, PR 00917
Phone (787) 766-1900

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1780367524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 7 BOX 17141",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009538844",
            "telephone_number": "787-293-7485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HACIENDAD DEL CARIBE",
            "address_2": "CALLE YUQUIYU I-9",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "00953",
            "telephone_number": "787-293-7485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Carr 651 KM 5.2 BO Dominguito",
            "address_purpose": "LOCATION",
            "city": "Arecibo",
            "state": "PR",
            "postal_code": "00612",
            "country_code": "US",
            "telephone_number": "787-293-7485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ DE JESUS",
        "first_name": "EDIBERTO III",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-09",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PR",
            "license": "1033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Alta, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.