Individual provider Active NPI

Victor M Gordo Gonzalez Sr., MD

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1124113899
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9049 Issued in PR
Practice address
Ave Ponce de Leon # 708
Suite 204
San Juan, PR 00918-1000
Phone
(787) 756-8186
Fax
(787) 281-0036
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9049 PR Primary

Addresses

Primary practice location

Ave Ponce de Leon # 708
Suite 204
San Juan, PR 00918-1000

Mailing address

Cond San Francisco Javier Num 406
Calle San Jose Num 50
Guaynabo, PR 00969
Phone (787) 756-8186

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
I20150724009832 PR Practitioner - Internal Medicine 7113230806 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Rehabilitation Services IncGroup PAC ID 0345406187, shared by 2 NPIs, 51 clinicians

Practice addresses (Care Compare)

Uu43 Calle
Suite 30
Bayamon, PR 00956-4701
Phone (787) 787-8669

Hospital & facility affiliations

  • Auxilio Mutuo Hospital Hospital, San Juan, PR, CCN 400016

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
66.19
Improvement activities
40
Cost
73.97

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Mar 1, 2015 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Mar 1, 2015 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. Past Accepting new patients

Locations

715 Ave Ponce de Leon
#375
San Juan, PR 00917
Phone (787) 504-1100

715 Ave Ponce de Leon
Ste 1
San Juan, PR 00917
Phone 7877582000 ext. 1391

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1124113899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND SAN FRANCISCO JAVIER NUM 406",
            "address_2": "CALLE SAN JOSE NUM 50",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-756-8186",
            "fax_number": "787-281-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE PONCE DE LEON # 708",
            "address_2": "SUITE 204",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009181000",
            "telephone_number": "787-756-8186",
            "fax_number": "787-281-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDO GONZALEZ",
        "first_name": "VICTOR",
        "middle_name": "M",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "9049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.