Ernesto Medina de Jesus, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

14975 Issued in PR

Practice address

62 Calle Mendez Alvarez
San Lorenzo, PR 00754-3537

Phone

(787) 736-6359

NPI assigned

Apr 25, 2006

Last updated

Oct 22, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Centro de Salud Integral Caguas

  • Health Maintenance Organization
  • Caguas, PR
  • NPI 1801816400
  NPD (past)
• Centro Integrado Medico de Aibonito

  • Health Maintenance Organization
  • Aibonito, PR
  • NPI 1366465106
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1841256203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CALLE MENDEZ ALVAREZ",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "007543537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 CALLE MENDEZ ALVAREZ",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "007543537",
            "telephone_number": "787-736-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA DE JESUS",
        "first_name": "ERNESTO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Liz Maldonado, M.T.
• Mayra Maldonado, M.D.
• Moraida Martinez Morales
• Jose J Martinez Santana, M.D.
• Medical Transport Ambulance Inc
• Angel Luis Medina Orta
• Raphael Melendez, P.T.
• MF Dynamic Billing Corp
• Ruvva Milian, NL, CNC
• Fernando R Miranda-Ramirez, D.M.D.

• General Practice Physician in San Lorenzo, PR
• Providers in San Lorenzo, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.