RAUL SAN JUAN – Internal Medicine Physician, NPI 1124489331

RAUL SAN JUAN is a healthcare provider. based in Fort lauderdale, Florida. specializing in GENERAL PRACTICE. They hold a License No. OS16495 (FL). The NPI Number for RAUL SAN JUAN is 1124489331

Main info

Male
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
RAUL SAN JUAN
NPI
1124489331
Phone
(954) 771-2111
Address
4800 N FEDERAL HWY STE 200
Enumeration Date
15 March 2016
Last Update Date
12 September 2023

Doctor Profile

Medical School Name
NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Secondary Phone
9412733611
Graduation Year
2016 (10 years ago)
PAC ID
3971930371
Group Practice PAC ID
5092981118
Professional Enrollment ID
I20200225000998
Address ID
FL339525038PO2400XBLVD300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,466 GENERAL PRACTICE in FL

Provider Addresses for RAUL SAN JUAN

  • 4800 N FEDERAL HWY STE 200

    FORT LAUDERDALE, FL 333084611

    Phone: (954) 771-2111

    Fax: (954) 983-1152

    Type: Mailing

  • 2007 PALM BEACH LAKES BLVD

    WEST PALM BEACH, FL 334096501

    Phone: (561) 420-8555

    Fax: (561) 420-8550

    Type: Mailing

  • 8553 SHERATON DR

    MIRAMAR, FL 330252826

    Phone: (954) 732-0457

    Type: Location

  • 4613 S Orange Blossom Trl

    Orlando, FL 328391705

    Phone: (407) 232-9833

    Fax: (407) 232-9829

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $106.

Total Amount is formed as General ($106) + Research ($0) + Ownership ($0) = $106.

Last reported payment date: 2023-08-23 • Largest payer in this snapshot: BIOTISSUE HOLDINGS, INC. ($79).

Total Amount

$106

General + Research + Ownership

Payments

2

Total payment records

General Amount

$106

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-02-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200225000998IInternal MedicineFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes5249$0
99203New patient office or other outpatient visit, 30-44 minutes2525$0
View full utilization report →

Insurance plans in this area (ZIP 33308)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092981118View full group profile
NameSpecialtyState
General PracticeTX
Nurse PractitionerFL
Nurse PractitionerFL
Internal MedicineFL
Nurse PractitionerMD
General PracticePR
Family PracticeFL
General PracticeFL

Reviews

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Frequently asked questions

What identifier follows RAUL SAN JUAN across health systems?
The NPI 1124489331 uniquely identifies RAUL SAN JUAN in U.S. healthcare data.
Should I treat RAUL SAN JUAN as an active provider?
Patients and plans typically see RAUL SAN JUAN as active in the national extract.
What services align with RAUL SAN JUAN's listing?
RAUL SAN JUAN's public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to RAUL SAN JUAN?
RAUL SAN JUAN shows a connection to Fort Lauderdale, Florida in registry-derived data.
Why is information missing for RAUL SAN JUAN?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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