Individual provider Active NPI

Rafael Gonzalez, M.D.

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1487608840
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME89042 Issued in FL
Practice address
1479 NW 27TH Ave
Miami, FL 33125-2133
Phone
(305) 633-3776
Fax
(305) 633-4240
NPI assigned
May 20, 2006
Last updated
Sep 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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 ME89042 FL Primary

Addresses

Primary practice location

1479 NW 27TH Ave
Miami, FL 33125-2133

Mailing address

14332 SW 40TH Ter
Miami, FL 33175-7823
Phone (305) 633-3776

Other identifiers 1

IdentifierTypeStateIssuer
ME89042OtherFLFL MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040804001501 FL Practitioner - Internal MedicinePractitioner - General Practice 1153392972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinica Las Mercedes, LLCGroup PAC ID 5890750731, 5 clinicians

Practice addresses (Care Compare)

1479 NW 27TH Ave
Miami, FL 33125-2133
Phone (305) 633-3776

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Las Mercedes, LLC General Practice Current Accepting new patients
Clinica Las Mercedes, LLC CurrentSince Oct 29, 2004 Accepting new patients
Clinica Las Mercedes, LLC CurrentSince Oct 29, 2004 Accepting new patients
Theraservices,Inc PastSince Apr 6, 2005 Accepting new patients
Fraga Medical Center, Inc. General Practice PastSince Nov 6, 2017 Accepting new patients
Health Systems Network Inc Past Accepting new patients

Locations

1479 NW 27th Ave
Miami, FL 33125
Phone (305) 633-3776

6355 NW 36th St
Ste 1100
Virginia Gardens, FL 33166

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1487608840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14332 SW 40TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331757823",
            "telephone_number": "305-633-3776",
            "fax_number": "305-633-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 NW 27TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252133",
            "telephone_number": "305-633-3776",
            "fax_number": "305-633-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME89042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICAL LICENSE",
            "identifier": "ME89042",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.