Individual provider Active NPI

Lewis R Perez Gomez

  • Psychologist
  • Trujillo Alto, PR
National Provider Identifier
1710514807
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6541 Issued in PR
Practice address
P41 Calle 16
Trujillo Alto, PR 00976-3100
Phone
(787) 486-6032
NPI assigned
Mar 26, 2020
Last updated
Mar 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6541 PR Primary

Addresses

Primary practice location

P41 Calle 16
Trujillo Alto, PR 00976-3100

Mailing address

P41 Calle 16
Trujillo Alto, PR 00976-3100
Phone (787) 486-6032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1710514807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P41 CALLE 16",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009763100",
            "telephone_number": "787-486-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "P41 CALLE 16",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009763100",
            "telephone_number": "787-486-6032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ GOMEZ",
        "first_name": "LEWIS",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "6541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trujillo Alto, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.