Individual provider Active NPI

Hermes Manuel Gonzalez Rodriguez

  • General Practice Physician
  • Hatillo, PR
National Provider Identifier
1811537285
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22178 Issued in PR
Practice address
Carretera #2 KM86.6
Hatillo, PR 00659
Phone
(787) 680-2019
NPI assigned
Jan 13, 2020
Last updated
Mar 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 22178 PR Primary
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

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
I20210802002498 PR Practitioner - General Practice 1658775416 Reassigns benefits to 1 organization
Practice locations: Utuado, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Avenida Dr Susoni
Suite 121
Hatillo, PR 00659
Phone 7878984190406

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22178PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Corporacion Servicios Medicos Primarios Y Prevencion de Hatillo Family Medicine CurrentSince 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "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

Sources for this page

Verify at the official NPI Registry.