Samuel A Gonzalez, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

12702 Issued in PR

Practice address

La Fuente Town Center
Marginal 706 Ste 11139
Guayama, PR 00784

Phone

(787) 866-1500

Fax

(787) 866-1652

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Hematology/OncologyAlso: Internal Medicine

Education

Ponce School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Caribbean Health Alliance PSC

  • Oncology Clinic/Center
  • Guayama, PR
  • NPI 1437422714
  Medicare reassignment NPD Authorized official
• Southwest Oncology Clinic

  • Hematology & Oncology Physician
  • Guayama, PR
  • NPI 1699979765
  Authorized official Same address or phone
• Ponce Medical School Foundation Inc

  • Multi-Specialty Clinic/Center
  • Ponce, PR
  • NPI 1043208804
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1861474223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 177",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "007850177",
            "telephone_number": "787-866-1500",
            "fax_number": "787-866-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LA FUENTE TOWN CENTER",
            "address_2": "MARGINAL 706 STE 11139",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-866-1500",
            "fax_number": "787-866-1652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 NE 30th Ter",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Homestead",
            "state": "FL",
            "postal_code": "330337613",
            "country_code": "US",
            "telephone_number": "786-410-5358",
            "fax_number": "786-410-5180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Hospital San Antonio",
            "address_2": "Calle Dr Ramon Emeterio Betances #18 Norte",
            "address_purpose": "LOCATION",
            "city": "Mayaguez",
            "state": "PR",
            "postal_code": "00680",
            "country_code": "US",
            "telephone_number": "787-831-6422",
            "fax_number": "787-831-6428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SAMUEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME121889",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PR",
            "license": "12702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014027200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aurea Ermelinda Gonzalez
• Edmillyvee Gonzalez
• Jose Javier Gonzalez, RN
• Marielly Gonzalez, PSY.D.
• Myrna Gonzalez
• Grupo Medico Concepto Fisico
• Grupo Pediatria 2000 (Vision 2000 HCO)
• Grupo Quirurgico Sureste LLC
• Grupo Terapia Fisica Arco Reflejo, LLC
• Guayama Diagnostics

• Hematology & Oncology Physician in Guayama, PR
• Providers in Guayama, PR by specialty
• Hematology & Oncology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.