Individual provider Active NPI

Jan Paul Rosaly Martinez, MD

  • Nephrology Physician
  • Mayaguez, PR
National Provider Identifier
1942794573
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
23698 Issued in PR
Practice address
1050 Ave Los Corazones Ste 102
Mayaguez, PR 00680-7058
Phone
(787) 834-5334
NPI assigned
Jun 18, 2018
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 34392 FL
Nephrology Physician 207RN0300X 23698 PR Primary

Addresses

Primary practice location

1050 Ave Los Corazones Ste 102
Mayaguez, PR 00680-7058

Mailing address

1050 Ave Los Corazones Ste 102
Mayaguez, PR 00680-7058
Phone (787) 834-5334

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
I20240703004203 PR Practitioner - Nephrology 8123469251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nefrologos Asociados del OesteGroup PAC ID 1951297951, 7 clinicians

Practice addresses (Care Compare)

1050 Ave Los Corazones
Mayaguez, PR 00680-7042
Phone (787) 834-5334

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23698PRMDPharmacy Technician
34392FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Nefrologos Asociados del Oeste Single Specialty CurrentSince Jul 1, 2024 Accepting new patients

Locations

1050 Ave Los Corazones
Ste 102
Mayaguez, PR 00680
Phone (787) 834-2185

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.

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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1942794573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 AVE LOS CORAZONES STE 102",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006807058",
            "telephone_number": "787-834-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 AVE LOS CORAZONES STE 102",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006807058",
            "telephone_number": "787-834-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSALY MARTINEZ",
        "first_name": "JAN",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "34392",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PR",
            "license": "23698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.