Individual provider Active NPI

Ismael Gonzalez Arce, MD

  • General Practice Physician
  • Hatillo, PR
National Provider Identifier
1477529592
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9688 Issued in PR
Practice address
137 Calle B
Bo Carrizales
Hatillo, PR 00659-1646
Phone
(787) 898-4590
Fax
(787) 898-4590
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 3

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.

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
I20101102001139 PR Practitioner - General Practice 6103010251 Reassigns benefits to 1 organization
Practice locations: Hatillo, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9688PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Emergency Physicians, PSC Past Accepting new patients
Emergency Medicine Group of Arecibo Inc Past Accepting new patients

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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 9688 PR Primary

Addresses

Primary practice location

137 Calle B
Bo Carrizales
Hatillo, PR 00659-1646

Mailing address

HC 01 Box 7900
Hatillo, PR 00659-9706
Phone (787) 383-9775

Other identifiers 6

IdentifierTypeStateIssuer
10903OtherSES HORARIO EXT
P865OtherFIRST MEDICAL
100158OtherMMM
M9665OtherCRUZ ACUL
2866OtherPREFERRED
6590038OtherHUMANA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 2, 2012.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1477529592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 01 BOX 7900",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006599706",
            "telephone_number": "787-383-9775",
            "fax_number": "787-898-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 CALLE B",
            "address_2": "BO CARRIZALES",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006591646",
            "telephone_number": "787-898-4590",
            "fax_number": "787-898-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ ARCE",
        "first_name": "ISMAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SES HORARIO EXT",
            "identifier": "10903",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST MEDICAL",
            "identifier": "P865",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM",
            "identifier": "100158",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ ACUL",
            "identifier": "M9665",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED",
            "identifier": "2866",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "6590038",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatillo, PR

Sources for this page

Verify at the official NPI Registry.