Individual provider Active NPI

Jorge Carlos Cheleuitte Semidey, M.D.

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1972039790
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
021224 Issued in PR
Practice address
1395 San Rafael
San Juan, PR 00910-3428
Phone
(787) 999-7620
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 021224 PR Primary

Addresses

Primary practice location

1395 San Rafael
San Juan, PR 00910-3428

Mailing address

PO Box 1842
Guaynabo, PR 00970

Other practice location 1

50 Calle Sergio Cuevas Bustamante
Ave Domenech
San Juan, PR 00918
Phone (787) 758-8383

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
I20201110000531 PR Practitioner - General Practice 6800206434 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021224PRMDGeneral Practice Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1972039790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1842",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 SAN RAFAEL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009103428",
            "telephone_number": "787-999-7620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Calle Sergio Cuevas Bustamante",
            "address_2": "Ave Domenech",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00918",
            "country_code": "US",
            "telephone_number": "787-758-8383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHELEUITTE SEMIDEY",
        "first_name": "JORGE",
        "middle_name": "CARLOS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "021224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.