Individual provider Active NPI

Marcos Mercado de Gorgolas, M.D.

  • Neurological Surgery Physician
  • Manati, PR
National Provider Identifier
1033147889
Registry record updated Mar 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
14613 Issued in PR
Practice address
Manati Medical Center Dr Otero Lopez
Suite 201
Manati, PR 00674
Phone
(787) 621-3737
Fax
(787) 621-3251
NPI assigned
Jun 29, 2006
Last updated
Mar 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 14613 PR Primary

Addresses

Primary practice location

Manati Medical Center Dr Otero Lopez
Suite 201
Manati, PR 00674

Mailing address

E1 Calle Miramonte
Garden Court
Guaynabo, PR 00966-2032
Phone (787) 621-3740

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
I20040621000175 PR Practitioner - Neurosurgery 9133104649 Practice locations: Manati, PR

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University Central del Caribe Escuela de Medicina, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

Manati Medical Center
201 Carr Hernandez Carrion Urb Atenas
Manati, PR 00674-1142
Phone (787) 621-3740

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion41
Laminectomy or laminotomy (partial removal of spine bones)26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14613PRMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas Neurological Surgery 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553904000000",
    "number": "1033147889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E1 CALLE MIRAMONTE",
            "address_2": "GARDEN COURT",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662032",
            "telephone_number": "787-621-3740",
            "fax_number": "787-621-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MANATI MEDICAL CENTER DR OTERO LOPEZ",
            "address_2": "SUITE 201",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-621-3737",
            "fax_number": "787-621-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO DE GORGOLAS",
        "first_name": "MARCOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2019-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PR",
            "license": "14613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.