Ivelisse Gonzalez, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

10207 Issued in PR

Practice address

Suite 603#68 St. Cruz St
Torre San Pablo Suite #603
Bayamon, PR 00961-7035

Phone

(787) 786-2469

NPI assigned

Mar 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physical Medicine and Rehabilitation

Education

Ponce School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• San Pablo Physical Medicine PSC

  • Rehabilitation Clinic/Center
  • Bayamon, PR
  • NPI 1679625131
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1508827403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#J10 6TH SREET",
            "address_2": "EL MIRADOR DE CUPEY",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009267571",
            "telephone_number": "787-748-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUITE 603#68 ST. CRUZ ST",
            "address_2": "TORRE SAN PABLO SUITE #603",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617035",
            "telephone_number": "787-786-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "IVELISSE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PR",
            "license": "10207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "82563GO",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Enrique A Gonzalez, DMD
• Eric M Gonzalez, MD, MPH
• Gloria Francisca Gonzalez, DIETITIAN
• Glorivette Gonzalez, LND
• Iraida Gonzalez
• Janitza Marie Gonzalez, RNA
• Joanne Gonzalez, M.D.
• Jorge Luis Gonzalez
• Lee R Gonzalez, M.D.
• Luis E. Gonzalez, D.M.D.,M.S.

• Physical Medicine & Rehabilitation Physician in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Physical Medicine & Rehabilitation Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.