Individual provider Active NPI

Juan Carlos Santiago Gonzalez, MD

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1821582073
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22646 Issued in PR
Practice address
Bo Monacillos Centro Medico de Puerto Rico
San Juan, PR 00935-0001
Phone
(787) 754-0101
NPI assigned
Jun 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 15125I PR
Internal Medicine Physician 207R00000X 22646 PR Primary

Addresses

Primary practice location

Bo Monacillos Centro Medico de Puerto Rico
San Juan, PR 00935-0001

Mailing address

Monacillos Carr 22 Centro Medico de Puerto Rico
San Juan, PR 00935-0001
Phone (787) 754-0101

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
I20230406001532 PR Practitioner - Internal Medicine 5597130492 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15125IPRMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas Internal Medicine CurrentSince Dec 1, 2022 Accepting new patients
Recinto de Ciencias Medicas CurrentSince Dec 1, 2022 Accepting new patients
Recinto de Ciencias Medicas Internal Medicine CurrentSince Jun 9, 2023 Accepting new patients

Locations

BO Monacillos Ctro Medico
San Juan, PR 00935

BO Monacillos Centro Medico De Puerto Rico
San Juan, PR 00935
Phone (781) 763-4149

Organizations & group practices 3

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1821582073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MONACILLOS CARR 22 CENTRO MEDICO DE PUERTO RICO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-754-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO MONACILLOS CENTRO MEDICO DE PUERTO RICO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-754-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO GONZALEZ",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "15125I",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "22646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.