Individual provider Active NPI

Modesto Fernando Gonzalez del Rosario

  • Pulmonary Disease Physician
  • Hato Rey, PR
National Provider Identifier
1538127014
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
5694 Issued in PR
Practice address
735 Ponce de Leon
Suite 716
Hato Rey, PR 00917
Phone
(787) 765-3079
Fax
(787) 767-7170
NPI assigned
May 3, 2006
Last updated
Sep 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 5694 PR Primary

Addresses

Primary practice location

735 Ponce de Leon
Suite 716
Hato Rey, PR 00917

Mailing address

735 Ponce de Leon
Suite 716
Hato Rey, PR 00917
Phone (787) 765-3079

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
I20101004000356 PR Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 5890875074 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Respiratory Care Specialists LLP Pulmonary Disease CurrentSince Oct 1, 1984 Accepting new patients

Locations

735 Ave Ponce de Leon
Ste 716
San Juan, PR 00917
Phone (787) 765-3078

Organizations & group practices 1

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1538127014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 PONCE DE LEON",
            "address_2": "SUITE 716",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-765-3079",
            "fax_number": "787-767-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 PONCE DE LEON",
            "address_2": "SUITE 716",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-765-3079",
            "fax_number": "787-767-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ DEL ROSARIO",
        "first_name": "MODESTO",
        "middle_name": "FERNANDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PR",
            "license": "5694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hato Rey, PR

Sources for this page

Verify at the official NPI Registry.