Individual provider Active NPI

Carlos Enrique Gonzalez Camacho, MD

  • Obstetrics & Gynecology Physician
  • Manati, PR
National Provider Identifier
1790885614
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5871 Issued in PR
Practice address
Urb Atenas Calle Hernandez Carrion
Manati Medical Center Suite 103
Manati, PR 00674
Phone
(787) 854-3115
Fax
(787) 884-5016
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5871 PR Primary

Addresses

Primary practice location

Urb Atenas Calle Hernandez Carrion
Manati Medical Center Suite 103
Manati, PR 00674

Mailing address

PO Box 1090
Manati, PR 00674
Phone (787) 854-3115

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
I20120806000137 PR Practitioner - Obstetrics/Gynecology 0042466120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Delta OB-GYN Group CSPGroup PAC ID 4385890466, 2 clinicians

Practice addresses (Care Compare)

Calle Hernandez Carrion
Urb Atenas J 8
Manati, PR 00674
Phone (787) 884-5016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5871PRMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Delta OB-GYN Group CSP Obstetrics & Gynecology CurrentSince Sep 25, 2011 Accepting new patients

Organizations & group practices 1

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1790885614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-854-3115",
            "fax_number": "787-884-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB ATENAS CALLE HERNANDEZ CARRION",
            "address_2": "MANATI MEDICAL CENTER SUITE 103",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-854-3115",
            "fax_number": "787-884-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ CAMACHO",
        "first_name": "CARLOS",
        "middle_name": "ENRIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PR",
            "license": "5871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.