Individual provider Active NPI

Jose Ramon Marrero Russe, MD

  • Specialist
  • Humacao, PR
National Provider Identifier
1821073495
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
7633 Issued in PR
Practice address
15 E Ave Padre Rivera
Humacao, PR 00791-0001
Phone
(787) 852-1945
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7633 PR Primary

Addresses

Primary practice location

15 E Ave Padre Rivera
Humacao, PR 00791-0001

Mailing address

Calle Acapulco 1005
Miramar
Isabela, PR 00662-0001
Phone (787) 360-2717

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
I20050314000028 PR Practitioner - Anesthesiology 3375598394 Reassigns benefits to 1 organization
Practice locations: Arecibo, PR; Humacao, PR

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University Central del Caribe Escuela de Medicina, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

55 Calle Palma
Arecibo, PR 00612-4526
Phone (787) 650-1030

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grupo Anestesiologo del Norte LLC Specialist CurrentSince Jul 1, 2021 Accepting new patients
Dba Humacao Anesthesia Service PastSince Sep 1, 2016 Accepting new patients
Humacao Anesthesia Services LLC PastSince Sep 3, 2016 Accepting new patients

Locations

55 Calle Palma
Arecibo, PR 00612
Phone (787) 605-0374

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1821073495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE ACAPULCO 1005",
            "address_2": "MIRAMAR",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006620001",
            "telephone_number": "787-360-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E AVE PADRE RIVERA",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007910001",
            "telephone_number": "787-852-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO RUSSE",
        "first_name": "JOSE",
        "middle_name": "RAMON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "7633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.