NPIMap

Individual provider Active NPI

Javier Gonzalez Buonomo, MD

  • Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
  • San German, PR
National Provider Identifier
1679922272
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Brain Injury Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P0301X
License
22377 Issued in PR
Practice address
Carr 2 KM 173
San German, PR 00683
Phone
(787) 672-4442
NPI assigned
Jun 6, 2016
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician 2081P0301X 22377 PR Primary

Addresses

Primary practice location

Carr 2 KM 173
San German, PR 00683

Mailing address

Calle la Cima #105 Gran Vista 1
Gurabo, PR 00778
Phone (787) 672-4442

Other practice location 1

Bo Monacillos
University District Hospital Puerto Rico Medical Center
San Juan, PR 00935-0001
Phone (787) 754-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210827000736 PR Practitioner - Physical Medicine and Rehabilitation 5092110155 Reassigns benefits to 1 organization
Practice locations: San German, PR

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University Central del Caribe Escuela de Medicina, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Carr 2 KM 173
San German, PR 00683-0001
Phone (787) 604-7919

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22377PRMDBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurorehab Institute LLC Brain Injury Medicine CurrentSince Jun 20, 2023 Accepting new patients
Ayala Troche, MD, C.S.P. CurrentSince Jul 20, 2021 Accepting new patients
Hospital de la Concepcion Inc Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1679922272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE LA CIMA #105 GRAN VISTA 1",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-672-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 2 KM 173",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-672-4442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Bo Monacillos",
            "address_2": "University District Hospital Puerto Rico Medical Center",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009350001",
            "country_code": "US",
            "telephone_number": "787-754-0101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ BUONOMO",
        "first_name": "JAVIER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0301X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": "PR",
            "license": "22377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

Verify at the official NPI Registry.