JERRDAM MEDICAL, CSP
NPI 1043381080
Specialist in Rio Piedras, PR
About Jerrdam Medical, Csp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JERRDAM MEDICAL, CSP (NPI 1043381080) is a healthcare organization registered as a specialist in Rio Piedras, Puerto Rico and active in the NPI registry since November 2006. The organization lists Jorge A Ruiz Roman, Presidente, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jerrdam Medical, Csp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Jerrdam Medical, Csp, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jerrdam Medical, Csp's NPI number?
The NPI number for Jerrdam Medical, Csp is 1043381080. It was assigned to this organization in the NPPES registry on November 13, 2006.
Where is Jerrdam Medical, Csp located?
Jerrdam Medical, Csp is located at Calle 21 U 3#5 Las Lomas, Rio Piedras, PR 00921. The listed phone number is (787) 775-2545.
What is Jerrdam Medical, Csp's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Jerrdam Medical, Csp enrolled in Medicare?
Yes. Jerrdam Medical, Csp is registered in the Medicare PECOS enrollment system.
When is Jerrdam Medical, Csp's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Puerto Rico, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Jerrdam Medical, Csp?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Jerrdam Medical, Csp, in Dermatology and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Jerrdam Medical, Csp was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jerrdam Medical, Csp · NPI 1043381080
Specialist organization in Rio Piedras, Puerto Rico. Organization record, active in the CMS NPPES registry since November 13, 2006.
## Identity
- **NPI:** 1043381080 (Entity type: Organization)
- **Enumerated:** November 13, 2006
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Jorge Ruiz Roman, PRESIDENTE
## Practice location
- **Address:** CALLE 21 U 3#5, LAS LOMAS, Rio Piedras, PR 00921
- **Phone:** (787) 775-2545
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Puerto Rico, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (1), Internal Medicine (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1043381080) · Data from the CMS NPPES public registry.