Individual provider Active NPI

Jose R Medrano Perez III, MD

  • Family Medicine Physician
  • Mayaguez, PR
National Provider Identifier
1952817645
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19853 Issued in PR
Practice address
Carr 349 KM 2.7 Cerro Las Mesas
Mayaguez, PR 00680-8321
Phone
(787) 834-6000
NPI assigned
Dec 18, 2017
Last updated
Aug 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19853 PR Primary
General Practice Physician 208D00000X 19853 PR

Addresses

Primary practice location

Carr 349 KM 2.7 Cerro Las Mesas
Mayaguez, PR 00680-8321

Mailing address

I23 Calle 1
Estancias de San Fernando
Carolina, PR 00985
Phone (787) 225-5959

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
I20190923001184 PR Practitioner - General Practice 2264762921 Reassigns benefits to 3 organizations
Practice locations: Aguadilla, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19853PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bella Vista Hospital Inc CurrentSince Feb 15, 2022 Accepting new patients
Bella Vista Hospital, Inc CurrentSince Feb 15, 2022 Accepting new patients
Hospital Comunitario Buen Samaritano Inc CurrentSince May 21, 2020 Accepting new patients
Bella Vista Hospital, Inc Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Hospital Comunitario Buen Samaritano Inc CurrentSince May 21, 2020 Accepting new patients

Locations

770 Ave Hostos
#M
Mayaguez, PR 00682

Organizations & group practices 5

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": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1952817645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "I23 CALLE 1",
            "address_2": "ESTANCIAS DE SAN FERNANDO",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-225-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 349 KM 2.7 CERRO LAS MESAS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006808321",
            "telephone_number": "787-834-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO PEREZ",
        "first_name": "JOSE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "19853",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19853",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.