Carlos Alberto Gonzalez-Berdecia

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

6748 Issued in PR

Practice address

Urb. Las Delicias
1204 Calle Fco. Vasallo
Ponce, PR 00728-3838

Phone

(787) 840-3510

Fax

(787) 840-3510

NPI assigned

Sep 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1699878017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7503",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007327503",
            "telephone_number": "787-840-3510",
            "fax_number": "787-840-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. LAS DELICIAS",
            "address_2": "1204 CALLE FCO. VASALLO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007283838",
            "telephone_number": "787-840-3510",
            "fax_number": "787-840-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-BERDECIA",
        "first_name": "CARLOS",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "6748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "27891GO",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "061882",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE Y MUCHO MAS",
            "identifier": "200049",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "7320071",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONAL MEDICAL CAR",
            "identifier": "2881",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UIA",
            "identifier": "3606748",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremie Gonzalez Romero, LT
• Antonio Gonzalez Sotomayor, M.D.
• Nahomi Gonzalez Viera, PSY D
• Yolanda E Gonzalez Zamora
• Adriana M Gonzalez-Arango, CPHT
• Ana Evelyn Gonzalez-Gomez
• Andrea R Gonzalez-Quintero, MD
• Anacelys Gonzalez-Viera, PHARM.D.,BCPS
• Ana M Gonzalez, PSY.D
• Anndra Aimee Gonzalez

• General Practice Physician in Ponce, PR
• Providers in Ponce, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.