Fabiola Gonzalez Ortiz

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

23535 Issued in PR

Practice address

Bo. Molinas Carr 365 KM 3.4 Int
Saban Grande, PR 00637-2600

Phone

(787) 892-5300

NPI assigned

Feb 1, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Specialty

General Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centro de Salud de Lares IncGroup PAC ID 0840272985, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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 de Salud de Lares, Inc

  • Federally Qualified Health Center (FQHC)
  • Quebradillas, PR
  • NPI 1235179532

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Centro de Salud de Lares, Inc

  • Community/Retail Pharmacy
  • Lares, PR
  • NPI 1093544132
  NPD

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1184189334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006590357",
            "telephone_number": "787-547-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO. MOLINAS CARR 365 KM 3.4 INT",
            "city": "SABAN GRANDE",
            "state": "PR",
            "postal_code": "006372600",
            "telephone_number": "787-892-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ ORTIZ",
        "first_name": "FABIOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "23535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.