Individual provider Active NPI

Jose Omar Allende Escalera, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1902527948
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
24030 Issued in PR
Practice address
Condominio Parque Loyola
Apartment 503
San Juan, PR 00918
Phone
(787) 232-7619
NPI assigned
Sep 8, 2022
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 24030 PR Primary

Addresses

Primary practice location

Condominio Parque Loyola
Apartment 503
San Juan, PR 00918

Mailing address

PO Box 1845
Arecibo, PR 00613-1845
Phone (787) 356-3220

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
I20241014000102 PR Practitioner - General Practice 0648702944 Practice locations: Fajardo, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24030PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Innova Therapy Services PastSince Sep 11, 2022 Accepting new patients

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": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1902527948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006131845",
            "telephone_number": "787-356-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CONDOMINIO PARQUE LOYOLA",
            "address_2": "APARTMENT 503",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-232-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLENDE ESCALERA",
        "first_name": "JOSE OMAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.