Individual provider Active NPI

German Luis Gonzalez Gonzalez, M.D.

  • Public Health & General Preventive Medicine Physician
  • San German, PR
National Provider Identifier
1679666739
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
16660 Issued in PR
Practice address
Carretera # 2 KM 174.0
San German Medical Plaza Suite 202
San German, PR 00683-1905
Phone
(787) 264-2124
NPI assigned
Oct 2, 2006
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 16660 PR Primary

Addresses

Primary practice location

Carretera # 2 KM 174.0
San German Medical Plaza Suite 202
San German, PR 00683-1905

Mailing address

PO Box 923
Hormigueros, PR 00660-0923
Phone (787) 264-2124

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
I20061207000233 PR Practitioner - General Practice 9133128887 Reassigns benefits to 1 organization
Practice locations: San German, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carr 2 KM 171
San German, PR 00683
Phone (787) 264-2124

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
GLG Preventive Medicine Center,PSC Current Accepting new patients
GLG Preventive Medicine Center PSC General Practice CurrentSince Feb 24, 2022 Accepting new patients

Organizations & group practices 2

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1679666739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 923",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "006600923",
            "telephone_number": "787-264-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA # 2 KM 174.0",
            "address_2": "SAN GERMAN MEDICAL PLAZA SUITE 202",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006831905",
            "telephone_number": "787-264-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ GONZALEZ",
        "first_name": "GERMAN",
        "middle_name": "LUIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "PR",
            "license": "16660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

Verify at the official NPI Registry.