Individual provider Active NPI

Jasmin Gonzalez-Camacho, BCMBT, LMT

  • Massage Therapist
  • Luquillo, PR
National Provider Identifier
1073030441
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
718 Issued in PR
Practice address
153-A Marginal Fortuna
Luquillo, PR 00773
Phone
(787) 465-0819
NPI assigned
Aug 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MAS8027 SC
Massage Therapist 225700000X MT010105 GA
Massage Therapist 225700000X MA68855 FL
Massage Therapist 225700000X 718 PR Primary

Addresses

Primary practice location

153-A Marginal Fortuna
Luquillo, PR 00773

Mailing address

PO Box 2252
Fajardo, PR 00738-2252
Phone (787) 379-7772

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

State licenses

LicenseStateTypeSpecialty
MA68855FLMDMassage Therapist
MT010105GAMDMassage Therapist
MAS8027SCMDMassage Therapist
718PRMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1503792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1073030441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2252",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007382252",
            "telephone_number": "787-379-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153-A MARGINAL FORTUNA",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "00773",
            "telephone_number": "787-465-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-CAMACHO",
        "first_name": "JASMIN",
        "name_prefix": "Ms.",
        "credential": "BCMBT, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-27",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "SC",
            "license": "MAS8027",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT010105",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA68855",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "PR",
            "license": "718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Luquillo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.