Individual provider Active NPI

David Molina Gonzalez, GP

  • Family Medicine Physician
  • Camuy, PR
National Provider Identifier
1043202468
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7735 Issued in PR
Practice address
4 Calle Santiago Rivera Morell
Camuy, PR 00627-2603
Phone
(787) 820-4617
Fax
(787) 820-4617
NPI assigned
Aug 22, 2005
Last updated
Feb 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7735 PR Primary

Addresses

Primary practice location

4 Calle Santiago Rivera Morell
Camuy, PR 00627-2603

Mailing address

PO Box 1328
Hatillo, PR 00659-1328
Phone (787) 820-4617

Other identifiers 2

IdentifierTypeStateIssuer
BG0900426OtherPRFEDERAL LICENSE
7735OtherPRMEDICAL LICENSE OF PR

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
I20110211000310 PR Practitioner - General Practice 6406036227 Practice locations: Camuy, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7735PRMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1043202468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1328",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006591328",
            "telephone_number": "787-820-4617",
            "fax_number": "787-820-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CALLE SANTIAGO RIVERA MORELL",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "006272603",
            "telephone_number": "787-820-4617",
            "fax_number": "787-820-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA GONZALEZ",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "GP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "7735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL LICENSE",
            "identifier": "BG0900426",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE OF PR",
            "identifier": "7735",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camuy, PR

Sources for this page

Verify at the official NPI Registry.