Individual provider Active NPI

Jofgrek Oliveras Gotay, M.D.

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1053495218
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
13784 Issued in PR
Practice address
344 Urb Las Monjitas Calle Novicia
Ponce, PR 00730
Phone
(787) 843-3838
Fax
(787) 843-3838
NPI assigned
Oct 24, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 13784 PR Primary

Addresses

Primary practice location

344 Urb Las Monjitas Calle Novicia
Ponce, PR 00730

Mailing address

PO Box 800073
Coto Laurel, PR 00780-0073
Phone (787) 840-3470

Other practice location 1

1255 Paseo Las Monjitas # 1255
suite # 123
Ponce, PR 00730-4220
Phone (787) 843-3838

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
I20040515000461 PR Practitioner - General Practice 1850381385 Practice locations: Ponce, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1255 Paseo Las Monjitas
Suite 123
Ponce, PR 00730-4221
Phone (787) 843-3838

PO Box
Coto Laurel, PR 00780

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13784PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Policlinicas de Ponce 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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053495218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800073",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007800073",
            "telephone_number": "787-840-3470",
            "fax_number": "787-840-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 URB LAS MONJITAS CALLE NOVICIA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-843-3838",
            "fax_number": "787-843-3838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 Paseo Las Monjitas # 1255",
            "address_2": "suite # 123",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "007304220",
            "country_code": "US",
            "telephone_number": "787-843-3838",
            "fax_number": "787-843-3838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVERAS GOTAY",
        "first_name": "JOFGREK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "13784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.