Individual provider Active NPI

Wigberto Josue Gonzalez Martinez, MD,MPH

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1265935928
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19863 Issued in PR
Practice address
70 Calle Santa Cruz
Bayamon, PR 00961-7052
Phone
(787) 620-4747
NPI assigned
Mar 8, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 19863 PR Primary

Addresses

Primary practice location

70 Calle Santa Cruz
Bayamon, PR 00961-7052

Mailing address

1 Calle 11 Apt 705
San Juan, PR 00926-6043

Other names 1

  • Wigberto Josue Gonzalez Martinez Former name

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
I20180809004193 PR Practitioner - General Practice 7113275025 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19863PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc CurrentSince Nov 18, 2018 Accepting new patients
Centro Medico del Turabo Inc Single Specialty CurrentSince Nov 18, 2018 Accepting new patients

Locations

70 Calle Santa Cruz
Bayamon, PR 00961
Phone (787) 620-1639

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

404 Ave General Valero
Fajardo, PR 00738
Phone (781) 299-4731

Organizations & group practices 2

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": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1265935928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CALLE 11 APT 705",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 CALLE SANTA CRUZ",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617052",
            "telephone_number": "787-620-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ MARTINEZ",
        "first_name": "WIGBERTO",
        "middle_name": "JOSUE",
        "credential": "MD,MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "19863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WIGBERTO",
            "last_name": "GONZALEZ MARTINEZ",
            "middle_name": "JOSUE",
            "credential": "MD,MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.