Active NPI
Ismael Medina-Gaud, M.D.
- Gynecology Physician
- Aguadilla, PR
National Provider Identifier
1396769121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 4253
- Practice address
- 43 Ave Severiano Cuevas
Suite 1
Aguadilla, PR 00603-5766 - Phone
- (787) 891-4865
- Fax
- (787) 891-4865
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 4253 | PR | Primary |
Addresses
Primary practice location
43 Ave Severiano Cuevas
Suite 1
Aguadilla, PR 00603-5766
Mailing address
PO Box 3929
Aguadilla, PR 00605-3929
Phone (787) 891-4865
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120413000481 | PR | Practitioner - Obstetrics/Gynecology | 3779744016 | Practice locations: Aguadilla, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4253 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396769121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3929",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "006053929",
"telephone_number": "787-891-4865",
"fax_number": "787-891-4865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 AVE SEVERIANO CUEVAS",
"address_2": "SUITE 1",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "006035766",
"telephone_number": "787-891-4865",
"fax_number": "787-891-4865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA-GAUD",
"first_name": "ISMAEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "PR",
"license": "4253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aguadilla, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.