Individual provider Active NPI

Gerardo Quevedo-Bonilla, M.D.

  • Specialist
  • Bayamon, PR
National Provider Identifier
1720080930
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
7664 Issued in PR
Practice address
73 Calle Santa Cruz
Ste 204
Bayamon, PR 00961-6911
Phone
(787) 787-9030
Fax
(787) 786-1559
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7664 PR Primary

Addresses

Primary practice location

73 Calle Santa Cruz
Ste 204
Bayamon, PR 00961-6911

Mailing address

73 Calle Santa Cruz
Ste 204
Bayamon, PR 00961-6911
Phone (787) 787-9030

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
I20111128000067 PR Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 9638343874 Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology)
Education
University of Puerto Rico School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

73 Calle Santa Cruz
Edificio Medico Santa Cruz Suite 204
Bayamon, PR 00961-6941

Hospital & facility affiliations

  • Hospital Espanol Auxilio Mutuo San Pablo Hospital, Bayamon, PR, CCN 400109

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy340

National Provider Directory

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

Hospital & facility affiliations 1

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1720080930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 CALLE SANTA CRUZ",
            "address_2": "STE 204",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009616911",
            "telephone_number": "787-787-9030",
            "fax_number": "787-786-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 CALLE SANTA CRUZ",
            "address_2": "STE 204",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009616911",
            "telephone_number": "787-787-9030",
            "fax_number": "787-786-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEVEDO-BONILLA",
        "first_name": "GERARDO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "7664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.