Individual provider Active NPI

Antonio M. Maldonado Gonzalez, M.D.

  • Specialist
  • Arecibo, PR
National Provider Identifier
1801894670
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
6651 Issued in PR
Practice address
21 Ave de Diego
Arecibo, PR 00612-4546
Phone
(787) 878-6213
Fax
(787) 878-4244
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 6651 PR Primary

Addresses

Primary practice location

21 Ave de Diego
Arecibo, PR 00612-4546

Mailing address

21 Ave de Diego
Arecibo, PR 00612-4546
Phone (787) 878-6213

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
I20110201000675 PR Practitioner - Diagnostic Radiology 5890974281 Reassigns benefits to 1 organization
Practice locations: Arecibo, PR

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21 Ave de Diego
Arecibo, PR 00612
Phone (787) 878-6213

Ave de Diego
Suite 21
Arecibo, PR 00612

Avenida de Diego
Suite 21
Arecibo, PR 00612

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
San Lazargerd Medical II CSP CurrentSince Nov 10, 2017 Accepting new patients
Family Health Clinic of Caribbean, Inc CurrentSince Sep 7, 2016 Accepting new patients
Instituto Radiologico de Arecibo Past Accepting new patients
Radiologia del Turabo, C.S.P. Past Accepting new patients
Tulio L Ortiz Robles Past Accepting new patients

Organizations & group practices 5

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1801894670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 AVE DE DIEGO",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006124546",
            "telephone_number": "787-878-6213",
            "fax_number": "787-878-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 AVE DE DIEGO",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006124546",
            "telephone_number": "787-878-6213",
            "fax_number": "787-878-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO GONZALEZ",
        "first_name": "ANTONIO",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "6651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.