Individual provider Active NPI

Luis D Gonzalez Hernandez, MD

  • Psychiatry Physician
  • San Juan, PR
National Provider Identifier
1639119696
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
11121 Issued in PR
Practice address
El Amal
Ave Jesus T Pinero 210
San Juan, PR 00927
Phone
(787) 769-7855
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 11121 PR Primary

Addresses

Primary practice location

El Amal
Ave Jesus T Pinero 210
San Juan, PR 00927

Mailing address

130 Ave Winston Churchill
San Juan, PR 00926-6065
Phone (787) 769-7855

Other identifiers 1

IdentifierTypeStateIssuer
0083394MedicaidPR

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
I20050208000158 PR Practitioner - Psychiatry 8123079126 Practice locations: San Juan, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aps Clinics of Puerto Rico, Inc. Psychiatry Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1639119696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 AVE WINSTON CHURCHILL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266065",
            "telephone_number": "787-769-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EL AMAL",
            "address_2": "AVE JESUS T PINERO 210",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00927",
            "telephone_number": "787-769-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ HERNANDEZ",
        "first_name": "LUIS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "11121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083394",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.