Individual provider Active NPI

Rene Clemente Gomez, MD

  • Cardiovascular Disease Physician
  • Caguas, PR
National Provider Identifier
1437155389
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
003656 Issued in PR
Practice address
63 Goyco Street
Caguas, PR 00725-2828
Phone
(787) 744-5200
Fax
(787) 744-5200
NPI assigned
Jun 24, 2005
Last updated
Jun 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 003656 PR Primary

Addresses

Primary practice location

63 Goyco Street
Caguas, PR 00725-2828

Mailing address

PO Box 1117
Caguas, PR 00726-1117
Phone (787) 744-5200

Other identifiers 1

IdentifierTypeStateIssuer
95762GOOtherPRPRIVATE PLAN NO SSS

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
I20100902001128 PR Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 3577687144 Practice locations: Caguas, PR

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
University of Puerto Rico School of Medicine, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

63 Calle Goyco
Caguas, PR 00725-2828
Phone (787) 744-5200

63 Goyco St
Caguas, PR 00725-2828

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3656PRMDPsychologist
003656PRMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1437155389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1117",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007261117",
            "telephone_number": "787-744-5200",
            "fax_number": "787-744-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 GOYCO STREET",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007252828",
            "telephone_number": "787-744-5200",
            "fax_number": "787-744-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "RENE",
        "middle_name": "CLEMENTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PR",
            "license": "003656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PLAN NO   SSS",
            "identifier": "95762GO",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.