Individual provider Active NPI

Vivian Perez-Gomez, M.D.

  • Emergency Medicine Physician
  • Ponce, PR
National Provider Identifier
1699055772
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
18606 Issued in PR
Practice address
Calle Guadalupe Final, Departamento de Emergencia
Hospital San Lucas
Ponce, PR 00731
Phone
(787) 844-2080
NPI assigned
Aug 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 18606 PR Primary

Addresses

Primary practice location

Calle Guadalupe Final, Departamento de Emergencia
Hospital San Lucas
Ponce, PR 00731

Mailing address

Calle Guadalupe Final, Departamento de Emergencia
Hospital San Lucas
Ponce, PR 00731

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
I20141112000452 PR Practitioner - Emergency Medicine 7517189343 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18606PRMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc CurrentSince Sep 6, 2014 Accepting new patients
VI-P Services PSC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Sep 6, 2014 Accepting new patients

Locations

70 Calle Santa Cruz
Bayamon, PR 00961
Phone (787) 620-1639

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

917 Ave Tito Castro
Ponce, PR 00716
Phone (787) 560-4314

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1699055772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE GUADALUPE FINAL, DEPARTAMENTO DE EMERGENCIA",
            "address_2": "HOSPITAL SAN LUCAS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE GUADALUPE FINAL, DEPARTAMENTO DE EMERGENCIA",
            "address_2": "HOSPITAL SAN LUCAS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00731",
            "telephone_number": "787-844-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-GOMEZ",
        "first_name": "VIVIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "18606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.