NPIMap

Organization Active NPI

Grupo Geriatrico de Medicina de Familia, Inc.

  • Specialist
  • Bayamon, PR
National Provider Identifier
1295732535
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
7119 Issued in PR
Legal business name
GRUPO GERIATRICO DE MEDICINA DE FAMILIA, INC.
Practice address
Ij-3 Calle Palma Real P2
Urb Royal Palm
Bayamon, PR 00959
Phone
(787) 787-9694
Fax
(787) 787-9701
NPI assigned
Jul 1, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Carlos M. Gutierrez
Title
President
Phone
(787) 787-9694

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 7119 PR Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 8723 PR
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 9865 PR

Addresses

Primary practice location

Ij-3 Calle Palma Real P2
Urb Royal Palm
Bayamon, PR 00959

Mailing address

Ij-3 Calle Palma Real P2
Urb Royal Palm
Bayamon, PR 00959
Phone (787) 787-9694

Other identifiers 3

IdentifierTypeStateIssuer
100293OtherPRLA CRUZ AZUL DE PR
890448OtherPRMMM HEALTHCARE
3120OtherPRPREFERRED MEDICAL CHOICE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295732535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "IJ-3 CALLE PALMA REAL P2",
            "address_2": "URB ROYAL PALM",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-787-9694",
            "fax_number": "787-787-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "IJ-3 CALLE PALMA REAL P2",
            "address_2": "URB ROYAL PALM",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-787-9694",
            "fax_number": "787-787-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRUPO GERIATRICO DE MEDICINA DE FAMILIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-787-9694",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "7119",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "8723",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "9865",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA CRUZ AZUL DE PR",
            "identifier": "100293",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM HEALTHCARE",
            "identifier": "890448",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED MEDICAL CHOICE",
            "identifier": "3120",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.