Individual provider Active NPI

Jorge Melendez- Bonilla, MD

  • Gastroenterology Physician
  • San Juan, PR
National Provider Identifier
1902921364
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
3840 Issued in PR
Practice address
371 Calle de Diego
San Juan, PR 00923-3002
Phone
(787) 616-3459
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 3840 PR Primary

Addresses

Primary practice location

371 Calle de Diego
San Juan, PR 00923-3002

Mailing address

PO Box 11636
San Juan, PR 00922-1636
Phone (787) 616-3459

Other identifiers 2

IdentifierTypeStateIssuer
038136301MedicaidPR
95189OtherPRTRIPLE S

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
I20050618000115 PR Practitioner - GastroenterologyPractitioner - Internal Medicine 2466496567 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Puerto Rico School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

435 Ave Ponce de Leon
San Juan, PR 00917-3424
Phone (787) 616-3459

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy16
Upper gastrointestinal (GI) endoscopy for acid reflux29

National Provider Directory

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

Hospital & facility affiliations 2

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1902921364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11636",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009221636",
            "telephone_number": "787-616-3459",
            "fax_number": "787-793-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 CALLE DE DIEGO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009233002",
            "telephone_number": "787-616-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ- BONILLA",
        "first_name": "JORGE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "3840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038136301",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "95189",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.