Active NPI
Manuel Gonzalez, MD
- Clinic/Center
- Patillas, PR
National Provider Identifier
1215010087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 10283
- Practice address
- Calle Riefkhol 1a
Patillas, PR 00723 - Phone
- (787) 204-5480
- Fax
- (787) 839-9344
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 10283 | PR | Primary |
Addresses
Primary practice location
Calle Riefkhol 1a
Patillas, PR 00723
Mailing address
PO Box 1300
Patillas, PR 00723-1300
Phone (787) 204-5480
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120529000505 | PR | Practitioner - General Practice | 3274796313 | Practice locations: Patillas, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338336000000",
"number": "1215010087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1300",
"city": "PATILLAS",
"state": "PR",
"postal_code": "007231300",
"telephone_number": "787-204-5480",
"fax_number": "787-839-9344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE RIEFKHOL 1A",
"city": "PATILLAS",
"state": "PR",
"postal_code": "00723",
"telephone_number": "787-204-5480",
"fax_number": "787-839-9344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MANUEL",
"name_prefix": "Miss",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2012-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "PR",
"license": "10283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Patillas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.