Active NPI
Carlos A Goglas
- Primary Care Clinic/Center
- Santa Isabel, PR
National Provider Identifier
1053590265
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(3) exclusion effective Apr 18, 2013.
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- License
- 15672
- Practice address
- 11200 Calle Margarita
Hacienda Concordia
Santa Isabel, PR 00757-3122 - Phone
- (787) 845-0128
- NPI assigned
- Oct 24, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 15672 | PR | Primary |
Addresses
Primary practice location
11200 Calle Margarita
Hacienda Concordia
Santa Isabel, PR 00757-3122
Mailing address
11200 Calle Margarita
Hacienda Concordia
Santa Isabel, PR 00757-3122
Phone (787) 845-0128
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15672 | PR | MD | Primary Care Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1053590265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11200 CALLE MARGARITA",
"address_2": "HACIENDA CONCORDIA",
"city": "SANTA ISABEL",
"state": "PR",
"postal_code": "007573122",
"telephone_number": "787-845-0128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11200 CALLE MARGARITA",
"address_2": "HACIENDA CONCORDIA",
"city": "SANTA ISABEL",
"state": "PR",
"postal_code": "007573122",
"telephone_number": "787-845-0128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOGLAS",
"first_name": "CARLOS",
"middle_name": "A",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-24",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "PR",
"license": "15672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Isabel, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.