Individual provider Active NPI

Ricardo Manuel Gomez-Quintana

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1285037630
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
018896 Issued in PR
Practice address
3211 Maravilla
Urb. El Monte
Ponce, PR 00716-4817
Phone
(787) 317-5307
NPI assigned
Sep 30, 2014
Last updated
Sep 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 018896 PR Primary

Addresses

Primary practice location

3211 Maravilla
Urb. El Monte
Ponce, PR 00716-4817

Mailing address

3211 Calle Maravilla
Urb. El Monte
Ponce, PR 00716-4817

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
I20151102000205 PR Practitioner - General Practice 1355651530 Reassigns benefits to 2 organizations
Practice locations: Dorado, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatrix Medical Group of Puerto Rico PSCGroup PAC ID 0648496067, 4 clinicians

Practice addresses (Care Compare)

1451 Ashford Ave Condado
Ashford Presbyterian Community Hospital
San Juan, PR 00902-0032
Phone (787) 722-6004

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018896PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Puerto Rico, P.S.C CurrentSince Jan 26, 2023 Accepting new patients
Hospital Menonita de Cayey General Practice CurrentSince Sep 3, 2019 Accepting new patients
Hospital Menonita de Cayey CurrentSince Sep 3, 2019 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1285037630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 CALLE MARAVILLA",
            "address_2": "URB. EL MONTE",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 MARAVILLA",
            "address_2": "URB. EL MONTE",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164817",
            "telephone_number": "787-317-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ-QUINTANA",
        "first_name": "RICARDO",
        "middle_name": "MANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "018896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.