Individual provider Active NPI

Carmen Elizabeth Rodriguez-Gonzalez, M.D

  • Family Medicine Physician
  • Hormigueros, PR
National Provider Identifier
1821392044
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18119 Issued in PR
Practice address
Carr 2 KM 365 Plaza Monserrate 3 Local 4
Hormigueros, PR 00660
Phone
(787) 245-9802
NPI assigned
Jan 3, 2011
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18119 PR Primary

Addresses

Primary practice location

Carr 2 KM 365 Plaza Monserrate 3 Local 4
Hormigueros, PR 00660

Mailing address

PO Box 1012
Anasco, PR 00610-1012
Phone (787) 453-0107

Other identifiers 1

IdentifierTypeStateIssuer
18119OtherPRPROFESSIONAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address contacto@arfamilymd.com

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
I20141013001398 PR Practitioner - Family Practice 8123248275 Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

770 Ave Hostos
Mayaguez, PR 00682-1551
Phone (787) 834-6161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18119PRMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1821392044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1012",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006101012",
            "telephone_number": "787-453-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 2 KM 365 PLAZA MONSERRATE 3 LOCAL 4",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "00660",
            "telephone_number": "787-245-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-GONZALEZ",
        "first_name": "CARMEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-03",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "18119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "18119",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contacto@arfamilymd.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "Carr 2 Km 365 Plaza Monserrate 3 Local 4",
            "city": "Hormigueros",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hormigueros, PR

Sources for this page

Verify at the official NPI Registry.