Individual provider Active NPI

Johnny Hernandez Gonzalez

  • Orthopaedic Trauma Physician
  • Bayamon, PR
National Provider Identifier
1811962178
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
9578 Issued in PR
Practice address
Carimed PLZ
B-1 Calle Santa Cruz Suite 403
Bayamon, PR 00961-6928
Phone
(787) 798-7070
Fax
(787) 787-2107
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X 9578 PR Primary

Addresses

Primary practice location

Carimed PLZ
B-1 Calle Santa Cruz Suite 403
Bayamon, PR 00961-6928

Mailing address

B11 Eastside CT
Baldwin Park
Guaynabo, PR 00969-4117
Phone (787) 798-7070

Other identifiers 3

IdentifierTypeStateIssuer
6210026OtherPRHUMANA
81746OtherPRTRIPLE S
067660OtherPRCRUZ AZUL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110914000277 PR Practitioner - Orthopedic Surgery 6608047147 Reassigns benefits to 1 organization
I20161013000047 PA Practitioner - Orthopedic Surgery 6608047147

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas CurrentSince Oct 1, 1984 Accepting new patients
Recinto de Ciencias Medicas Orthopaedic Trauma CurrentSince Oct 1, 1984 Accepting new patients

Locations

Centro Medico De
San Juan, PR 00935
Phone (781) 763-4149

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1811962178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "B11 EASTSIDE CT",
            "address_2": "BALDWIN PARK",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694117",
            "telephone_number": "787-798-7070",
            "fax_number": "787-787-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARIMED PLZ",
            "address_2": "B-1 CALLE SANTA CRUZ SUITE 403",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009616928",
            "telephone_number": "787-798-7070",
            "fax_number": "787-787-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ GONZALEZ",
        "first_name": "JOHNNY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "PR",
            "license": "9578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "6210026",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "81746",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "067660",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.