Individual provider Active NPI

Johans Gonzalez Gonzalez, M.D.

  • General Practice Physician
  • Aguadilla, PR
National Provider Identifier
1083072052
Registry record updated Feb 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19551 Issued in PR
Practice address
Calle 2 Ave Severino Cuevas 18
Aguadilla, PR 00605-4055
Phone
(787) 658-0012
NPI assigned
Feb 5, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2017

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 19551 PR Primary

Addresses

Primary practice location

Calle 2 Ave Severino Cuevas 18
Aguadilla, PR 00605-4055

Mailing address

HC 1 Box 4722
Lares, PR 00669-9619
Phone (787) 383-9354

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
I20170726003147 PR Practitioner - General PracticePractitioner - General SurgeryPractitioner - Pain Management 7416227244 Reassigns benefits to 1 organization
Practice locations: Camuy, PR; Manati, PR

National Provider Directory

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486857600000",
    "number": "1083072052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 4722",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006699619",
            "telephone_number": "787-383-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 2 AVE SEVERINO CUEVAS 18",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006054055",
            "telephone_number": "787-658-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ GONZALEZ",
        "first_name": "JOHANS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-05",
        "last_updated": "2017-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguadilla, PR

Sources for this page

Verify at the official NPI Registry.