Hermes Manuel Gonzalez Rodriguez

Key facts

NPI: 1811537285
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Physician 208D00000X
License: 22178 (PR)
Practice address: Carretera #2 KM86.6
Hatillo, PR 00659
Phone: (787) 680-2019
NPI assigned: Jan 13, 2020
Sex: Male
Sole proprietor: Yes

Organizations & group practices 2

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.

Corporacion Servicios Medicos Primarios Y Prevencion de Hatillo Federally Qualified Health Center (FQHC) · Hatillo, PR · NPI 1306877279

Medicare reassignment Care Compare group NPD FAMILY MEDICINE · PR
Corporacion de Servicios Medicos Primarios Y Prevencion de Hatillo Community/Retail Pharmacy · Hatillo, PR · NPI 1659406015

NPD (past)

Medicare Care Compare profile

Specialty: General Practice
Education: Other, 2013
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Corporacion Servicios Medicos Primarios Y Prevencion de Hatillo (14 clinicians)

Practice addresses (Care Compare)

Avenida Dr Susoni
Suite 121
Hatillo, PR 00659
Phone 7878984190406

Medicare participation

Medicare fee-for-service enrollment: Enrolled in PR
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20210802002498	PR	Practitioner - General Practice	1658775416	Reassigns benefits to 1 organization Practice locations: Utuado, PR

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
22178	PR	MD	General Practice Physician

Practice roles

Organization	Specialty	Status	New patients
Corporacion Servicios Medicos Primarios Y Prevencion de Hatillo	Family Medicine	Current since Oct 2, 2023	Accepting new patients
Corporacion de Servicios Medicos Primarios Y Prevencion de Hatillo		Past	Accepting new patients

Locations

121 Ave Dr Susoni
Hatillo, PR 00659
Phone (787) 314-5291

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Physician	208D00000X	22178	PR	Yes
Family Medicine Physician	207Q00000X	22178	PR

Addresses

Primary practice location

Carretera #2 KM86.6
Hatillo, PR 00659

Mailing address

85 Calle Guacima
Barceloneta, PR 00617-2753
Phone (787) 680-2019

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 18, 2022.

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1811537285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 CALLE GUACIMA",
            "city": "BARCELONETA",
            "state": "PR",
            "postal_code": "006172753",
            "telephone_number": "787-680-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA #2 KM86.6",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "00659",
            "telephone_number": "787-680-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ RODRIGUEZ",
        "first_name": "HERMES",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-13",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22178",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "22178",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatillo, PR

All providers in Hatillo, PR · General Practice Physician in Puerto Rico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.