Individual provider Active NPI

Jorge David Jimenez Maldonado, MD

  • Family Medicine Physician
  • Manati, PR
National Provider Identifier
1942220181
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12522 Issued in PR
Practice address
Calle a Sur C 15 Flamboyan
Manati, PR 00674
Phone
(787) 884-6595
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12522 PR Primary

Addresses

Primary practice location

Calle a Sur C 15 Flamboyan
Manati, PR 00674

Mailing address

PO Box 2020
Barceloneta, PR 00617-2020
Phone (787) 884-6595

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
I20050503000047 PR Practitioner - Family Practice 9032158639 Reassigns benefits to 1 organization
Practice locations: Ciales, PR; Manati, PR

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Calle Hospital
Ciales, PR 00638-3310
Phone (787) 871-1098

Calle Hospital
4 Clinica de Cuidado Medico Inc
Ciales, PR 00638-3310

Hospital & facility affiliations

  • Manati Medical Center Dr Otero Lopez Hospital, Manati, PR, CCN 400114

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica de Cuidado Medico, Inc. CurrentSince Jan 17, 2014 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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1942220181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2020",
            "city": "BARCELONETA",
            "state": "PR",
            "postal_code": "006172020",
            "telephone_number": "787-884-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE A SUR C 15 FLAMBOYAN",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-884-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ MALDONADO",
        "first_name": "JORGE",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "12522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.