Active NPI
Ketsia Gonzalez, MD
- Medical Physician Assistant
- Ponce, PR
National Provider Identifier
1003524158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 1035
- Practice address
- 2225 Ponce Bypass Edificio Parra Suite 603
Ponce, PR 00717-0071 - Phone
- (787) 492-2000
- NPI assigned
- Nov 8, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 1035 | PR | Primary |
Addresses
Primary practice location
2225 Ponce Bypass Edificio Parra Suite 603
Ponce, PR 00717-0071
Mailing address
219 Bo Chino
Villalba, PR 00766-3002
Phone (872) 674-4784
Other names 1
- Dr. Ketsia Gonzalez Vazquez
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | asistente@icardiopr.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1035 | PR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667865600000",
"number": "1003524158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 BO CHINO",
"city": "VILLALBA",
"state": "PR",
"postal_code": "007663002",
"telephone_number": "872-674-4784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 PONCE BYPASS EDIFICIO PARRA SUITE 603",
"city": "PONCE",
"state": "PR",
"postal_code": "007170071",
"telephone_number": "787-492-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "KETSIA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-08",
"last_updated": "2022-11-08",
"certification_date": "2022-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PR",
"license": "1035",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "asistente@icardiopr.com",
"affiliation": "N",
"endpointDescription": "Work email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Messaging exchange with patient and pharmacies",
"address_1": "2225 Ponce Bypass Edificio Parra Suite 603",
"city": "Ponce",
"state": "PR",
"country_code": "US",
"postal_code": "007170071",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KETSIA",
"last_name": "GONZALEZ VAZQUEZ",
"prefix": "DR.",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.