Individual provider Active NPI

Rene Purcell-Jordan, M.D.

  • Emergency Medicine Physician
  • San Juan, PR
National Provider Identifier
1790991495
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13138 Issued in PR
Practice address
Urb. Laderas de San Juan
44 Calle Sauco
San Juan, PR 00926-9318
Phone
(787) 625-9425
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

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
Emergency Medicine Physician 207P00000X 13138 PR Primary

Addresses

Primary practice location

Urb. Laderas de San Juan
44 Calle Sauco
San Juan, PR 00926-9318

Mailing address

Urb. Laderas de San Juan
44 Calle Sauco
San Juan, PR 00926-9318
Phone (787) 625-9425

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
I20040903000290 PR Practitioner - Emergency Medicine 8820064595 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13138PRMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yauco Healthcare Corporation Past Accepting new patients
Platinum Emergency Physicians, PSC Emergency Medicine Past Accepting new patients
Rad Nucs LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790991495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. LADERAS DE SAN JUAN",
            "address_2": "44 CALLE SAUCO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009269318",
            "telephone_number": "787-625-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. LADERAS DE SAN JUAN",
            "address_2": "44 CALLE SAUCO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009269318",
            "telephone_number": "787-625-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL-JORDAN",
        "first_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "13138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.