Individual provider Active NPI

Jose Enrique Blasco-Jusino, DPM

  • Podiatrist
  • Miami, FL
National Provider Identifier
1790478097
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PR803 Issued in FL
Practice address
1201 NW 16TH St
Miami, FL 33125-1624
Phone
(305) 575-7000
NPI assigned
Jun 1, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PR803 FL Primary

Addresses

Primary practice location

1201 NW 16TH St
Miami, FL 33125-1624

Mailing address

1369 Urb. Mercedita
Bonita St.
Ponce, PR 00717-1624
Phone (787) 638-5908

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260601003857 PR Order and Referring Only - PodiatryPractitioner - Podiatry 0648740530

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

106 Paseo del Principe
Ponce, PR 00716

1494 FD Roosevelt Ave
Suite 101 Caparra Heights
San Juan, PR 00920
Phone (787) 782-1453

909 Ave Tito Castro
Suite 519
Ponce, PR 00716-4721
Phone (787) 705-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR803FLMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1790478097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1369 URB. MERCEDITA",
            "address_2": "BONITA ST.",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171624",
            "telephone_number": "787-638-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NW 16TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251624",
            "telephone_number": "305-575-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASCO-JUSINO",
        "first_name": "JOSE",
        "middle_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-01",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PR803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.