Jorge L Pena Ruiz I, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

8626 Issued in PR

Practice address

Calle Arzuaga #112 Rio Piedras
San Juan, PR 00925

Phone

(787) 767-8758

Fax

(844) 759-2967

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Dr. Pena L Jorge I Professional name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Physician H.M.O. Inc.

  • Intermediate Emergency Medical Technician
  • San Juan, PR
  • NPI 1730481649
  Medicare reassignment NPD

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1992867857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB.LAS SERRANIA",
            "address_2": "CALLE MADRIGAL #4",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-376-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE ARZUAGA #112 RIO PIEDRAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00925",
            "telephone_number": "787-767-8758",
            "fax_number": "844-759-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA RUIZ",
        "first_name": "JORGE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "1992867857",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "8626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37720900",
            "state": "PR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80393",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENA",
            "last_name": "JORGE",
            "middle_name": "L",
            "prefix": "DR.",
            "suffix": "I",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Katherine Pena Castillo, PA
• Ivelisse Pena Jimeno, MD
• Jennifer M Pena Moreira, M.D.
• Kathia M Pena Rios, PHD
• Alba Janice Pena Rivera, MSW
• Emmanuel Jose Pena Serrano, PH.D.
• Jiovanni Eldrick Pena-Melendez, MSW
• Doris Margarita Pena
• Hector Omar Pena, DC
• Lorna M Pena, M.A.

• Pediatrics Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Pediatrics Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.