Jose Manuel Gomez Vazquez, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

21210 Issued in PR

Practice address

Santurce Medical Mall
1801 Ave Ponce de Leon Suite 101 B
Santurce, PR 00921

Phone

(787) 728-6093

Fax

(787) 728-6093

NPI assigned

Jan 31, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Clinica Medicina Preventiva C.P.

  • General Practice Physician
  • San Juan, PR
  • NPI 1881155976
  NPD (past)

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1467916783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367083",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009367083",
            "telephone_number": "787-226-8890",
            "fax_number": "787-728-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SANTURCE MEDICAL MALL",
            "address_2": "1801 AVE PONCE DE LEON SUITE 101 B",
            "city": "SANTURCE",
            "state": "PR",
            "postal_code": "00921",
            "telephone_number": "787-728-6093",
            "fax_number": "787-728-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ VAZQUEZ",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Garcia
• Maribel Garcia, M.D.
• Genetic Diagnostic Group
• GHP C.S.P.
• Golden Cross Health Plan Corp.
• Carlos Alberto Gomez-Marcial, M.D.
• Lori Renee Gomez
• Mariana C Gomez, M.S
• Efrain Gonzalez Arroyo, M.D.
• Jose Ramon Gonzalez Chavez, M.D.

• General Practice Physician in Santurce, PR
• Providers in Santurce, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.

Verify at the official NPI Registry.