Individual provider Active NPI

Gabriel Montalvo-Castro, M.D.

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1851704589
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19155 Issued in PR
Practice address
66 Calle Santa Cruz
Instituto San Pablo Suite 307
Bayamon, PR 00961
Phone
(787) 798-8486
Fax
(787) 740-7170
NPI assigned
Jun 10, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME141853 FL
General Practice Physician 208D00000X 316085 NY
General Practice Physician 208D00000X 19155 PR Primary

Addresses

Primary practice location

66 Calle Santa Cruz
Instituto San Pablo Suite 307
Bayamon, PR 00961

Mailing address

PO Box 360160
San Juan, PR 00936-0160
Phone (787) 787-5151

Other practice location 1

Hf16 Calle Lizzie Graham
Toa Baja, PR 00949-3634
Phone (293) 578-7795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 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
I20151014000324 PR Practitioner - General Practice 0749599751 Reassigns benefits to 1 organization
I20200220003044 FL Practitioner - General Practice 0749599751

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME141853FLMDGeneral Practice Physician
316085NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrate Community Health System Current Accepting new patients
Integrate Community Health System, Inc. CurrentSince Mar 26, 2019 Accepting new patients
Integrate Community Health System CurrentSince Mar 26, 2019 Accepting new patients
Psychological Empowerment LLC PastSince Aug 25, 2015 Accepting new patients
Ian Family Medicine Inc PastSince Dec 1, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gabriel.montalvo.1@30885.direct.athenahealth.com

Organizations & group practices 5

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1851704589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360160",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009360160",
            "telephone_number": "787-787-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 CALLE SANTA CRUZ",
            "address_2": "INSTITUTO SAN PABLO SUITE 307",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-798-8486",
            "fax_number": "787-740-7170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Hf16 Calle Lizzie Graham",
            "address_purpose": "LOCATION",
            "city": "Toa Baja",
            "state": "PR",
            "postal_code": "009493634",
            "country_code": "US",
            "telephone_number": "293-578-7795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTALVO-CASTRO",
        "first_name": "GABRIEL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME141853",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "316085",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.