Individual provider Active NPI

Edwin D Soto Gonzalez, MD

  • General Practice Physician
  • Aguadilla, PR
National Provider Identifier
1154383727
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
8016 Issued in PR
Practice address
2053 Ave Pedro Albizu Campos
#3
Aguadilla, PR 00603
Phone
(787) 891-5130
Fax
(787) 891-5130
NPI assigned
Apr 6, 2006
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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 8016 PR Primary

Addresses

Primary practice location

2053 Ave Pedro Albizu Campos
#3
Aguadilla, PR 00603

Mailing address

PO Box 250437
Aguadilla, PR 00604-0437
Phone (787) 891-5130

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
I20121008000506 PR Practitioner - General Practice 1557510559 Practice locations: Aguadilla, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2053 Ave Pedro Albizu Campos
Suite 3
Aguadilla, PR 00603-5950
Phone (787) 891-5130

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8016PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Zone Aguadilla LLC Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1154383727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250437",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006040437",
            "telephone_number": "787-891-5130",
            "fax_number": "787-891-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2053 AVE PEDRO ALBIZU CAMPOS",
            "address_2": "#3",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-891-5130",
            "fax_number": "787-891-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO GONZALEZ",
        "first_name": "EDWIN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "8016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguadilla, PR

Sources for this page

Verify at the official NPI Registry.