Individual provider Active NPI

Jose R Gomez Geo, MD

  • Family Medicine Physician
  • Manati, PR
National Provider Identifier
1235596297
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19248 Issued in PR
Practice address
PR-149
Reparto Villa Alberta Suite #2
Manati, PR 00674
Phone
(787) 316-5424
NPI assigned
Jan 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 19248 PR
Family Medicine Physician 207Q00000X 19248 PR Primary

Addresses

Primary practice location

PR-149
Reparto Villa Alberta Suite #2
Manati, PR 00674

Mailing address

PO Box 414
Manati, PR 00674-0414
Phone (787) 854-6562

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
I20170202000388 PR Practitioner - General Practice 1052694817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consultorio Medico Clinico Dr. Gomez Adrover, PSCGroup PAC ID 4486895703, 2 clinicians

Practice addresses (Care Compare)

2 Villa Alberta
Manati, PR 00674-5636
Phone (787) 854-6562

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19248PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consultorio Medico Clinico Dr Gomez Adrover PSC CurrentSince Nov 28, 2016 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1235596297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740414",
            "telephone_number": "787-854-6562",
            "fax_number": "787-854-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PR-149",
            "address_2": "REPARTO VILLA ALBERTA SUITE #2",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-316-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ GEO",
        "first_name": "JOSE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-21",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19248",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "19248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.