Individual provider Active NPI

Gustavo Adolfo Munoz

  • General Practice Physician
  • Juana Diaz, PR
National Provider Identifier
1861623290
Registry record updated Aug 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17543 Issued in PR
Practice address
6 Calle la Cruz
Juana Diaz, PR 00795-2430
Phone
(787) 837-2265
NPI assigned
Aug 3, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17543 PR Primary

Addresses

Primary practice location

6 Calle la Cruz
Juana Diaz, PR 00795-2430

Mailing address

6 Calle la Cruz
Juana Diaz, PR 00795-2430
Phone (787) 837-2265

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
I20110118001214 PR Practitioner - General Practice 7719176080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Hospital Service IncGroup PAC ID 6709847239, 2 clinicians

Practice addresses (Care Compare)

40 Calle Munoz Rivera
Villalba, PR 00766-3040
Phone (787) 847-3000

Hospital & facility affiliations

  • Angeles San Cristobal Home health agency, Juana Diaz, PR, CCN 407033
  • Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas Inc Hospice, Ponce, PR, CCN 401530

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17543PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Hospital Services Inc CurrentSince Oct 8, 2018 Accepting new patients
Southern Hospital Service Inc Current Accepting new patients

Locations

6 Calle La Cruz
Juana Diaz, PR 00795
Phone (787) 837-2265

40 Calle Munoz Rivera
Villalba, PR 00766
Phone (787) 847-3000

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249257600000",
    "number": "1861623290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CALLE LA CRUZ",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007952430",
            "telephone_number": "787-837-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CALLE LA CRUZ",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007952430",
            "telephone_number": "787-837-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "GUSTAVO",
        "middle_name": "ADOLFO",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-03",
        "last_updated": "2009-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juana Diaz, PR

Sources for this page

Verify at the official NPI Registry.