Rafael Gonzalez DPM LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

000808 Issued in CT

Legal business name

RAFAEL GONZALEZ DPM LLC

Doing business as

Greater Hartford Podiatry

Practice address

580 Cottage Grove Rd Ste 203
Bloomfield, CT 06002-3088

Phone

(860) 263-7999

Fax

(860) 216-0664

NPI assigned

May 1, 2009

Last updated

Nov 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rafael Gonzalez, DPMNPI 1851349997

Title

Owner

Phone

(860) 263-7999

Specialties & licenses 3

Addresses

Other names 1

• Greater Hartford Podiatry Doing business as

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

Locations

Practitioners 1

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.

• Rafael Gonzalez, DPM LLC

  • Podiatrist
  • Bloomfield, CT
  • NPI 1851349997
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446768000000",
    "number": "1326282518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 COTTAGE GROVE RD",
            "address_2": "STE 203",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023088",
            "telephone_number": "860-263-7999",
            "fax_number": "860-216-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 COTTAGE GROVE RD STE 203",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023088",
            "telephone_number": "860-263-7999",
            "fax_number": "860-216-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAFAEL GONZALEZ DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2015-11-06",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-263-7999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "000808",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000808",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CT",
            "license": "000808",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Hartford Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Podiatrist in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.