Individual provider Active NPI

Carol M Jimenez Bague

  • Audiologist
  • Bayamon, PR
National Provider Identifier
1851469688
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
0573 Issued in PR
Practice address
100 Paseo San Pablo
Edif Arturo Cadilla Ofic 205
Bayamon, PR 00960
Phone
(787) 798-5000
Fax
(787) 292-5050
NPI assigned
Dec 1, 2006
Last updated
Jan 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 0573 PR Primary

Addresses

Primary practice location

100 Paseo San Pablo
Edif Arturo Cadilla Ofic 205
Bayamon, PR 00960

Mailing address

PO Box 193069
San Juan, PR 00919-3069
Phone (787) 761-0036

Other practice location 1

Manati Medical Plaza Carr#2 KM 48.3 #1 Jose Candelas St
Suite 203
Manati, PR 00674
Phone (787) 884-4629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130521000489 PR Practitioner - Qualified Audiologist 5991943532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision Hearing Center IncGroup PAC ID 2769650274, 37 clinicians

Practice addresses (Care Compare)

Calle Garcia de la Naceda a
6 Villas de Rio Grande
Rio Grande, PR 00745
Phone (787) 809-4322

Sector Urb Rio Grande Hill
Carr Num 3
Rio Grande, PR 00745
Phone (787) 809-4233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0573PRMDAudiologist
573PRMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Hearing Center Inc Single Specialty CurrentSince Jun 4, 2018 Accepting new patients

Locations

100 Paseo San Pablo
Ste 205
Bayamon, PR 00961
Phone (787) 786-5151

Interoperability endpoints

  • Direct secure messaging: cjimenezbague@2144.securemail.prognocis.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1851469688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193069",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009193069",
            "telephone_number": "787-761-0036",
            "fax_number": "787-292-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PASEO SAN PABLO",
            "address_2": "EDIF ARTURO CADILLA OFIC 205",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00960",
            "telephone_number": "787-798-5000",
            "fax_number": "787-292-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Manati Medical Plaza Carr#2 KM 48.3 #1 Jose Candelas St",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Manati",
            "state": "PR",
            "postal_code": "00674",
            "country_code": "US",
            "telephone_number": "787-884-4629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ BAGUE",
        "first_name": "CAROL",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PR",
            "license": "0573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.