Active NPI
Pablo A Gomez Cortes
- Land Ambulance
- Aguadilla, PR
National Provider Identifier
1851506265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- TC-AMB-411
- Practice address
- Carr 467 KM 4.4
Barrio Camaseyes
Aguadilla, PR 00603-1503 - Phone
- (787) 617-9110
- Fax
- (787) 890-0724
- NPI assigned
- May 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | TC-AMB-411 | PR | Primary |
Addresses
Primary practice location
Carr 467 KM 4.4
Barrio Camaseyes
Aguadilla, PR 00603-1503
Mailing address
137 Calle Harrison
Aguadilla, PR 00603-1503
Phone (787) 617-9110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 660670738 | Other | PR | IRS TAX ID # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060911000024 | PR | Part B Supplier - Ambulance Service Supplier | 3072517853 | Practice locations: Aguadilla, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TC-AMB-411 | PR | MD | Land Ambulance |
Organizations & group practices 1
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": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381795200000",
"number": "1851506265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 CALLE HARRISON",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "006031503",
"telephone_number": "787-617-9110",
"fax_number": "787-890-0724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 467 KM 4.4",
"address_2": "BARRIO CAMASEYES",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "006031503",
"telephone_number": "787-617-9110",
"fax_number": "787-890-0724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ CORTES",
"first_name": "PABLO",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-11",
"last_updated": "2013-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "PR",
"license": "TC-AMB-411",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IRS TAX ID #",
"identifier": "660670738",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Aguadilla, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.