NPIMap

Individual provider Active NPI

Jorge R Matta Gonzalez, MD

  • Child & Adolescent Psychiatry Physician
  • Caguas, PR
National Provider Identifier
1316006430
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
15959 Issued in PR
Practice address
50 Ave Luis Munoz Marin
Quadrangle Medical Center
Caguas, PR 00725-3975
Phone
(787) 744-0857
NPI assigned
Dec 6, 2006
Last updated
Nov 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 15959 PR
Child & Adolescent Psychiatry Physician 2084P0804X 15959 PR Primary

Addresses

Primary practice location

50 Ave Luis Munoz Marin
Quadrangle Medical Center
Caguas, PR 00725-3975

Mailing address

PO Box 9634
Caguas, PR 00726-9634
Phone (787) 744-0857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080620000072 PR Practitioner - Psychiatry 6406927391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York Medical College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Behavioral Care CorpGroup PAC ID 5294863262, 20 clinicians

Practice addresses (Care Compare)

202 Calle Gautier Benitez
Caguas, PR 00725-5512
Phone (787) 704-0705

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Behavioral Care Corp. Current Accepting new patients
Mennonite General Hospital Inc. CurrentSince Jul 3, 2020 Accepting new patients
Mennonite General Hospital Inc. CurrentSince Jul 3, 2020 Accepting new patients
Inspira Behavioral Care Corp. CurrentSince Jul 30, 2019 Accepting new patients
Inspira Behavioral Care Corp CurrentSince Jul 30, 2019 Accepting new patients
Mennonite General Hospital Inc Current Accepting new patients
Mennonite General Hospital Inc Past Accepting new patients
Inspira Behavioral Care Corp. Past Accepting new patients
Community Cornerstones Inc Past Accepting new patients
Inspira Behavioral Care Corp. Past Accepting new patients
Centro de Salud Conductual Menonita Cima Past Accepting new patients
Inspira Behavioral Care Corp. Past Accepting new patients
Inspira Behavioral Care Corp. Past Accepting new patients
Dr. Jorge R. Matta Gonzalez CSP Past Accepting new patients

Locations

431 Ave Hostos
San Juan, PR 00918
Phone 7877539515226

55 Calle Comercio
Yauco, PR 00698
Phone (787) 267-1810

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1316006430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9634",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007269634",
            "telephone_number": "787-744-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 AVE LUIS MUNOZ MARIN",
            "address_2": "QUADRANGLE MEDICAL CENTER",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007253975",
            "telephone_number": "787-744-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA GONZALEZ",
        "first_name": "JORGE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "15959",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PR",
            "license": "15959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.