Individual provider Active NPI

Rafael A Ruiz Gonzalez, M.D

  • Internal Medicine Physician
  • Canovanas, PR
National Provider Identifier
1902892458
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8374 Issued in PR
Practice address
Calle Bauinia Aa 3 Loiza Valley Mall
Canovanas, PR 00729
Phone
(787) 876-3007
Fax
(787) 876-2736
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8374 PR Primary

Addresses

Primary practice location

Calle Bauinia Aa 3 Loiza Valley Mall
Canovanas, PR 00729

Mailing address

Calle Orquidea 40 a Loiza Valley
Canovanas, PR 00729
Phone (787) 876-3007

Other identifiers 2

IdentifierTypeStateIssuer
1902892458OtherPRMCS
500382EOtherPRMMM

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
I20091218000211 PR Practitioner - Internal Medicine 4183764343 Practice locations: Canovanas, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8374PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctores R Ruiz LLC Internal Medicine Current Accepting new patients
Grupo Medico del Noreste PastSince Aug 2, 2009 Accepting new patients

Locations

AA3 Calle Bauhinia
Canovanas, PR 00729
Phone (787) 876-3007

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.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1902892458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE ORQUIDEA 40 A LOIZA VALLEY",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-876-3007",
            "fax_number": "787-876-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE BAUINIA AA 3 LOIZA VALLEY MALL",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-876-3007",
            "fax_number": "787-876-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ GONZALEZ",
        "first_name": "RAFAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "8374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCS",
            "identifier": "1902892458",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM",
            "identifier": "500382E",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canovanas, PR

Sources for this page

Verify at the official NPI Registry.