Carlos Ronald Pedraza Gonzalez, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

21590 Issued in PR

Practice address

Carr 2 KM 141.1 Ave Severiano Cuevas
Aguadilla, PR 00603

Phone

(787) 658-0200

NPI assigned

Jul 2, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Centro Medico del Turabo Inc

  • Multi-Specialty Clinic/Center
  • Caguas, PR
  • NPI 1710107883

  General Practice

  Medicare reassignment NPD
• Molecula1 LLC

  • General Practice Physician
  • Humacao, PR
  • NPI 1760170070
  NPD Authorized official
• Bella Vista Hospital Inc

  • General Acute Care Hospital
  • Mayaguez, PR
  • NPI 1083636179
  NPD
• Centro Medico del Turabo Inc

  • Home Infusion Therapy Pharmacy
  • Bayamon, PR
  • NPI 1811632581
  NPD

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1164918223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2304",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006762304",
            "telephone_number": "787-415-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 2 KM 141.1 AVE SEVERIANO CUEVAS",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-658-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRAZA GONZALEZ",
        "first_name": "CARLOS",
        "middle_name": "RONALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isis Padilla
• Albertino Padin -Gomez, MD
• Wilmayri Pagan Lopez
• Carmen Pagan
• Liza Mariel Paulo Malave, MD
• Maheliz Pellot-Fuentes
• Daisy Pellot-Rodriguez, PSY D.
• Carelys Pena, M.A.
• Pequenos Pasos LLC
• Eduardo Jose Perez Caban, M.D.

• General Practice Physician in Aguadilla, PR
• Providers in Aguadilla, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.