Individual provider Active NPI

Carlos A Gaona Reyes, MD

  • Internal Medicine Physician
  • Ponce, PR
National Provider Identifier
1003902743
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13489 Issued in PR
Practice address
1214 Ave Munoz Rivera
Recinto Universitario
Ponce, PR 00717
Phone
(787) 284-0383
Fax
(787) 987-9310
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13489 PR Primary

Addresses

Primary practice location

1214 Ave Munoz Rivera
Recinto Universitario
Ponce, PR 00717

Mailing address

460 Calle Gaviota
Camino del Sur
Ponce, PR 00716
Phone (787) 284-0383

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
I20091029000294 PR Practitioner - Internal Medicine 6507903200 Practice locations: Ponce, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13489PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ponce Medical School Foundation Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1003902743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 CALLE GAVIOTA",
            "address_2": "CAMINO DEL SUR",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00716",
            "telephone_number": "787-284-0383",
            "fax_number": "787-987-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 AVE MUNOZ RIVERA",
            "address_2": "RECINTO UNIVERSITARIO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00717",
            "telephone_number": "787-284-0383",
            "fax_number": "787-987-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAONA REYES",
        "first_name": "CARLOS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "13489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.