NPIMap

Organization Active NPI

Gold Star Medical LLC

  • Medical Specialty Clinic/Center
  • Hormigueros, PR
National Provider Identifier
1073289922
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
GOLD STAR MEDICAL LLC
Practice address
2 Ave Luis Munoz Marin
Hormigueros, PR 00660-1750
Phone
(787) 673-1238
NPI assigned
Aug 20, 2021
Last updated
Sep 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Shahid M Chaudhary, MDNPI 1932187499
Title
Medical Director
Phone
(787) 673-1238

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU Primary
Primary Care Clinic/Center 261QP2300X NU
Radiology Clinic/Center 261QR0200X NU
Clinical Medical Laboratory 291U00000X NU

Addresses

Primary practice location

2 Ave Luis Munoz Marin
Hormigueros, PR 00660-1750

Mailing address

#184 Calle Valencia
Urb. la Salamanca
San German, PR 00683
Phone (787) 673-1238

Other identifiers 1

IdentifierTypeStateIssuer
371248OtherPRREGISTER NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1073289922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#184 CALLE VALENCIA",
            "address_2": "URB. LA SALAMANCA",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-673-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 AVE LUIS MUNOZ MARIN",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "006601750",
            "telephone_number": "787-673-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD STAR MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "CHAUDHARY",
        "authorized_official_first_name": "SHAHID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "787-673-1238",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTER NUMBER",
            "identifier": "371248",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hormigueros, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.