Active NPI
Ismael Gonzalez Maldonodo, M.D.
- General Practice Physician
- Penuelas, PR
National Provider Identifier
1427897404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 023857
- Practice address
- HC 3 Box 13261
Penuelas, PR 00624-9822 - Phone
- (787) 901-6892
- NPI assigned
- May 21, 2024
- Last updated
- Sep 16, 2024
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 023857 | PR | Primary |
Addresses
Primary practice location
HC 3 Box 13261
Penuelas, PR 00624-9822
Mailing address
HC 3 Box 13261
Penuelas, PR 00624-9822
Phone (787) 901-6892
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023857 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1427897404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 3 BOX 13261",
"city": "PENUELAS",
"state": "PR",
"postal_code": "006249822",
"telephone_number": "787-901-6892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HC 3 BOX 13261",
"city": "PENUELAS",
"state": "PR",
"postal_code": "006249822",
"telephone_number": "787-901-6892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ MALDONODO",
"first_name": "ISMAEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-21",
"last_updated": "2024-09-16",
"certification_date": "2024-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "023857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penuelas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.