Individual provider Active NPI

Lismari Charity Gonzalez Santos, MD

  • Student in an Organized Health Care Education/Training Program
  • Bayamon, PR
National Provider Identifier
1083390975
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
17751 Issued in PR
Practice address
PO Box 306
Bayamon, PR 00960-0306
Phone
(787) 620-8181
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 17751 PR Primary

Addresses

Primary practice location

PO Box 306
Bayamon, PR 00960-0306

Mailing address

Brisas del Campanero 1 Calle Isaias F-25 Buzon 572
Toa Baja, PR 00949
Phone (939) 400-6200

Other practice location 1

Brisas del Campanero 1 Calle Isaias f-25 buzon 572
Toa Baja, PR 00949
Phone (939) 400-6200

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17751PRMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Bayamon Medical Center Corp PastSince Feb 16, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1083390975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BRISAS DEL CAMPANERO 1 CALLE ISAIAS F-25 BUZON 572",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "00949",
            "telephone_number": "939-400-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009600306",
            "telephone_number": "787-620-8181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Brisas del Campanero 1 Calle Isaias f-25 buzon 572",
            "address_purpose": "LOCATION",
            "city": "Toa Baja",
            "state": "PR",
            "postal_code": "00949",
            "country_code": "US",
            "telephone_number": "939-400-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ SANTOS",
        "first_name": "LISMARI",
        "middle_name": "CHARITY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "17751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.