Individual provider Active NPI

Jaemilyn Perez, RN, BSN.

  • Registered Nurse
  • Arecibo, PR
National Provider Identifier
1902568124
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
092043 Issued in PR
Practice address
446 Ave Juan Rosado
Arecibo, PR 00612-4265
Phone
(787) 880-0384
NPI assigned
Oct 6, 2021
Last updated
Oct 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 092043 PR Primary

Addresses

Primary practice location

446 Ave Juan Rosado
Arecibo, PR 00612-4265

Mailing address

PO Box 863
Lares, PR 00669-0863
Phone (787) 394-7502

Other identifiers 1

IdentifierTypeStateIssuer
092043MedicaidPR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
092043PRMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Jun 23, 2025 Accepting new patients
Walgreen Co PastSince Oct 10, 2021 Accepting new patients

Locations

446 Ave Juan Rosado
Arecibo, PR 00612
Phone (787) 815-2122

Organizations & group practices 2

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": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1902568124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690863",
            "telephone_number": "787-394-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 AVE JUAN ROSADO",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006124265",
            "telephone_number": "787-880-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JAEMILYN",
        "name_prefix": "Miss",
        "credential": "RN, BSN.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "092043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092043",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.