Individual provider Active NPI

Luis M Gonzalez Bermudez, MD

  • General Practice Physician
  • Comerio, PR
National Provider Identifier
1376577924
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9663 Issued in PR
Practice address
Street 778 KM 0.9 Bo Pasarell
Comerio, PR 00782
Phone
(787) 875-3136
Fax
(787) 875-4904
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 9663 PR Primary

Addresses

Primary practice location

Street 778 KM 0.9 Bo Pasarell
Comerio, PR 00782

Mailing address

PO Box 1103
Comerio, PR 00782-1103
Phone (787) 875-3136

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
I20040803000277 PR Practitioner - General PracticePractitioner - Pain Management 1759351596 Practice locations: Vega Alta, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13 8 Carr
693 Suite 171 Bo Brenas
Vega Alta, PR 00692
Phone (787) 270-4747

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9663PRMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Life Force Health Organization Inc CurrentSince Aug 7, 2014 Accepting new patients
Angelorum Inc. Past Accepting new patients
Vega Baja Community Health Past Accepting new patients
Comerio Medical Hospital Inc PastSince Nov 28, 2001 Accepting new patients
Comerio Medical Hospital Inc Past Accepting new patients
Rincon Medical Center PastSince Jun 1, 2004 Accepting new patients
Municipality of Toa Baja PastSince Feb 18, 2004 Accepting new patients
Vega Baja Community Health PastSince Mar 16, 2004 Accepting new patients

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376577924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1103",
            "city": "COMERIO",
            "state": "PR",
            "postal_code": "007821103",
            "telephone_number": "787-875-3136",
            "fax_number": "787-875-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STREET 778 KM 0.9 BO PASARELL",
            "city": "COMERIO",
            "state": "PR",
            "postal_code": "00782",
            "telephone_number": "787-875-3136",
            "fax_number": "787-875-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ BERMUDEZ",
        "first_name": "LUIS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Comerio, PR

Sources for this page

Verify at the official NPI Registry.