Active NPI
Jorge E Corzo, MD
- Family Medicine Physician
- San Juan, PR
National Provider Identifier
1790787000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4890
- Practice address
- 1789 Carr 21 Ste 306
San Juan, PR 00921-3337 - Phone
- (787) 781-0059
- Fax
- (787) 273-1722
- NPI assigned
- Jun 1, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4890 | PR | Primary |
Addresses
Primary practice location
1789 Carr 21 Ste 306
San Juan, PR 00921-3337
Mailing address
Tierra Alta III I-14 Ruisenor St
Guaynabo, PR 00969-3347
Phone (787) 781-0059
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110328000787 | PR | Practitioner - Family Practice | 4082897103 | Practice locations: San Juan, PR |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Torre del Metropolitano
Carr 21 1789 Suite 306
San Juan, PR 00921-3333
Phone (787) 781-0059
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4890 | PR | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350518400000",
"number": "1790787000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "TIERRA ALTA III I-14 RUISENOR ST",
"city": "GUAYNABO",
"state": "PR",
"postal_code": "009693347",
"telephone_number": "787-781-0059",
"fax_number": "787-273-1722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1789 CARR 21 STE 306",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009213337",
"telephone_number": "787-781-0059",
"fax_number": "787-273-1722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORZO",
"first_name": "JORGE",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2012-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PR",
"license": "4890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.
- 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.