Individual provider Active NPI

Carlos J. Gonzalez Garcia, M.D.

  • Diagnostic Radiology Physician
  • San Juan, PR
National Provider Identifier
1336334481
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
020777 Issued in PR
Practice address
617 Calle Europa
San Juan, PR 00909-2210
Phone
(787) 625-1446
NPI assigned
Sep 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 250224 MA
Diagnostic Radiology Physician 2085R0202X 020777 PR Primary

Addresses

Primary practice location

617 Calle Europa
San Juan, PR 00909-2210

Mailing address

617 Calle Europa
San Juan, PR 00909-2210
Phone (787) 625-1446

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
I20131010001675 PR Practitioner - Diagnostic Radiology 9638303464 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ponce School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
M and P Radiologos, LLCGroup PAC ID 1254397094, 21 clinicians

Practice addresses (Care Compare)

1462 Calle Profesor Augusto Rodriguez
San Juan, PR 00910-1137
Phone (787) 641-1616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
29.05 of 100Reported as group
Quality
16.53
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250224MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ponce Neuroradiological Services, PSC Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
Dla Imaging LLC Diagnostic Radiology CurrentSince Aug 5, 2024 Accepting new patients
Fajardo Integrated Medical Center CurrentSince Aug 16, 2024 Accepting new patients
Zenith Health Group LLC Past Accepting new patients

Locations

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

Organizations & group practices 6

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.

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": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1336334481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 CALLE EUROPA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092210",
            "telephone_number": "787-625-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 CALLE EUROPA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092210",
            "telephone_number": "787-625-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ GARCIA",
        "first_name": "CARLOS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "250224",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PR",
            "license": "020777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.