Individual provider Active NPI

David W Colon-Golderos, MD

  • General Practice Physician
  • Rio Grande, PR
National Provider Identifier
1114926342
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
12516 Issued in PR
Practice address
Calle Main A23
Alturas de Rio Grande
Rio Grande, PR 00745-3473
Phone
(787) 657-5496
Fax
(787) 657-5343
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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 12516 PR Primary

Addresses

Primary practice location

Calle Main A23
Alturas de Rio Grande
Rio Grande, PR 00745-3473

Mailing address

PO Box 1901
Canovanas, PR 00729-1901
Phone (787) 657-5496

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
I20050330000047 PR Practitioner - General Practice 8123074473 Practice locations: Rio Grande, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
San Juan Bautista School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

A23 Calle
Suite 1
Rio Grande, PR 00745
Phone (787) 657-5496

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alturas Medical CSP Past Accepting new patients
Prestige Medical Group Ljcpsc Past Accepting new patients
Lba Medical Services Inc General Practice PastSince Sep 5, 2017 Accepting new patients

Organizations & group practices 3

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1114926342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1901",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007291901",
            "telephone_number": "787-657-5496",
            "fax_number": "787-657-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE MAIN A23",
            "address_2": "ALTURAS DE RIO GRANDE",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "007453473",
            "telephone_number": "787-657-5496",
            "fax_number": "787-657-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON-GOLDEROS",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "12516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, PR

Sources for this page

Verify at the official NPI Registry.